ABSTRACT
Objective: To assess the role of single nucleotide polymorphisms [SNPs] near the interferon lambda-3 [IFNX3] [formal IL-28B] gene rs12979860 in predicting sustained virologic response [SVR] in hepatitis-C virus genotype-3 [HCV-3]
Study Design: Descriptive, analytical study
Place and Duration of Study: Department of Medicine, The Aga Khan University Hospital, Karachi, from July 2012 to June 2014
Methodology: Patients with HCV-3 were classified as sustained virologic response [SVR], relapsers and non-responders. SNP rs12979860 was determined by PCR-RFLP protocol. Differences between categorical variables were assessed by chi-square or Fisher's exact test, while those between continuous variables were evaluated using the Mann-Whitney U-test. Binary logistic regression analysis by forward conditional method was performed by using significant variables with p-values less than 0.05 as the criteria for model inclusion
Results: Out of 115 patients, rs12979860 genotype-CC, CT, TT was found in 37 [32.2%], 70 [60.9%], and 8 [7%] patients. 72 patients were male with median age of 45 years. Cirrhosis was present in 32 patients. Patients with response failures [no response and relapse, n=36 and 29, respectively] had higher baseline gamma glutamyl transferase [GOT] level [p < 0.001], higher alanine aminotransferase [p=0.027] and cirrhosis [p=0.001] than patients with SVR. Genotype-CC was present in 16/65 in response failures compared to 21/50 who achieved SVR [p=0.048]. Rapid virologic response [RVR] [p < 0.001], low GGT [p=0.001] and absence of cirrhosis [p=0.039] were the independent predictive factors for SVR. In patients who could not achieve RVR and in patients with cirrhosis, SVR was seen more in with genotype-CC [p=0.007 and 0.038]
Conclusion: In patients infected with HCV-3, IFNA3 rs12979860, SNP has less impact on SVR
ABSTRACT
To assess the nutritional status via the SGA [subjective global assessment] screening tool of patients at all stages of hepatitis C virus [HCV] liver disease. Descriptive study. Out-patient Clinics of the Aga Khan University Hospital, Karachi, conducted from October 2009 to January 2011. Patients with hepatitis C virus infection and their HCV-negative attendants were enrolled from the outpatient clinics, and categorized into 4 groups of 100 patients each: healthy controls [HC], those with chronic hepatitis C infection [CHC], compensated cirrhotics [CC] and decompensated cirrhotics [DC]. The validated subjective global assessment [SGA] tool was used to assess nutritional status. A total of 400 patients were enrolled. Most of the patients in the HC group were class A [best nutritional status]. In contrast, the majority [64%] in the DC group were in the class C [worst status]. The compensated cirrhosis [CC] group showed that 90% of patients were malnourished, while 98% of all patients were malnourished in the DC group, predominantly class C. Most importantly, 14% of patients with chronic hepatitis C [CHC] also scored a B on the SGA; which when compared to HC was statistically significant [p=0.005]. As the groups progressed in their disease from CHC to DC, the transition in nutritional status from A to C between groups was statistically significant. Malnutrition occurs early in the course of HCV, and progresses relentlessly throughout the spectrum of HCV disease