«Pitfalls» in the treatment of patients with chronic hepatitis C infected with genotype 2 or 3 hepatitis C virus
AbstractThe results of clinical and laboratory examination of 29 patients with chronic hepatitis C infected with genotype 2 or 3 HCV, treated with pegylated interferon and ribavirin for 24 weeks were analyzed. The evaluation of the role of factors, predictors of SVR in patients with chronic hepatitis C infected with genotype 2 or 3 HCV, taking into account the characteristics of the viral genome was performed. In the studied group treatment was ineffective in 14% (4/29) of cases. Patients who did not respond to therapy, have known predictors of failure (such as obesity, the presence of hepatic steatosis and initially high viral load), as well as factors related to the characteristics of the virus. In two patients, the main cause of treatment failure was the presence of a recombinant variant RF2k/1b HCV, undetectable by standard commercial test systems when determining the genotype of the virus. In one case, sequencing revealed the presence of mixed infection genotypes 1b and 3a HCV. It is recommended to determine the HCV genotype prior to the antiviral therapy by testing with systems, which allow subtyping genotype 1 NS5V-region, or sequencing of the NS5B-region HCV genome.
Keywords:chronic hepatitis C, treatment, predictors of SVR, genotypes 2 and 3 hepatitis C virus, HCV recombinant variants