BACKGROUND: Homozygosity for the PNPLA3 p.I148M polymorphism influences steatosis and fibrogenesis in chronic hepatitis C (CHC). AIM: To evaluate the effect of p.148M/M on sustained virological response (SVR) and viral kinetics in patients who underwent antiviral therapy with peg-interferon and ribavirin, stratified according to viral genotype and fibrosis severity, and secondarily, the interaction with interleukin-28B ( IL28B ) genotype on liver damage. METHODS: In this observational study, we considered 602 treatment-naïve consecutive patients from tertiary referral centres in Milan and Vienna [61% genotype 1 (G1), 30% advanced fibrosis, 33% IL28B rs12979860 CC]. RESULTS: The p.148M/M genotype, detected in 8% of patients, did not influence SVR in the overall series (P = 0.29), but it was associated with SVR (3/17, 17% vs. 56/121, 46%; P = 0.034) and complete early viral response (4/17, 23% vs. 68/121, 56%; P = 0.018) in G1/4 patients with advanced fibrosis. After adjustment for age, viral load, IL28B CC genotype, treatment dose, and steatosis, p.148M/M remained a predictor of SVR in G1/4 patients with advanced fibrosis (OR 0.23, 95% CI 0.04-0.87). The p.148M/M genotype was associated with more advanced fibrosis in the overall series (P = 0.049), whereas the rs12979860 IL28B CC genotype only in patients negative for p.148M/M (P = 0.017), independently of age, BMI and alanine transaminase levels (OR 1.51, 95% CI 1.01-2.27). CONCLUSIONS: PNPLA3 p.148M/M genotype was negatively associated with SVR and early viral kinetics independently of steatosis, albeit only in difficult-to-cure G1/4 patients with advanced fibrosis, whereas stratification for the p.148M/M PNPLA3 genotype unmasked an association between IL28B CC genotype and more severe liver fibrosis.
Implications of PNPLA3 polymorphism in chronic hepatitis C patients receiving peginterferon plus ribavirin / L.V.C. Valenti, A. Aghemo, A.F. Stättermayer, P. Maggioni, S. De Nicola, B.M. Motta, M.G. Rumi, P. Dongiovanni, P. Ferenci, M. Colombo, S.R. Fargion. - In: ALIMENTARY PHARMACOLOGY & THERAPEUTICS. - ISSN 0269-2813. - 35:12(2012 Jun), pp. 1434-1442.
|Titolo:||Implications of PNPLA3 polymorphism in chronic hepatitis C patients receiving peginterferon plus ribavirin|
VALENTI, LUCA VITTORIO CARLO (Primo)
COLOMBO, MASSIMO GIUSEPPE (Penultimo)
FARGION, SILVIA ROSSANA (Ultimo)
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
|Data di pubblicazione:||giu-2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/j.1365-2036.2012.05109.x|
|Appare nelle tipologie:||01 - Articolo su periodico|