Centre de Recherche en Cancérologie de Lyon (CRCL), INSERM U1052/CNRS UMR5286, Lyon, France.
Unique serum anti-E1E2 antibodies were shown to be associated with spontaneous recovery or predictive of sustained virological response (SVR) in patients with chronic hepatitis C receiving pegylated-interferon/ribavirin (PEG-IFN/RBV) therapy. The objectives were (1) to establish the relationship between pretreatment anti-E1E2 titers and HCV RNA kinetics during PEG-IFN/RBV therapy, and (2) to examine whether the combined determination of IL28B rs12979860 and rs8099917, pretreatment IP-10 levels and/or anti-E1E2 improved the prediction of SVR.
Sera from 26 naive consecutive HCV patients treated with PEG-IFN/RBV for 48 weeks were analyzed. Serum anti-E1E2 titers and pretreatment IP-10 levels were measured by enzyme-linked immunosorbent assays. The IL28B variants were determined using genotyping real-time polymerase chain reaction method. Viral decline was measured at weeks (W) 4 and 12 and SVR assessed 6 months after the end of therapy.
Baseline anti-E1E2 titers were correlated with HCV RNA decline at W4 and W12 and were highly predictive of SVR with 100% of patients negative for anti-E1E2 failing to achieve SVR. ROC curve analyses indicate that the best prediction of SVR (AUC 0.990) was obtained with the combination of anti-E1E2 and IP-10 levels. Predictive values were better than those obtained with IP-10 alone or in combination with IL28B variants.
Pretreatment serum anti-E1E2 response predicts HCV RNA clearance kinetics and treatment outcome. The combination of anti-E1E2 and IP-10 significantly improve the prediction of treatment response. This warrants further investigation and validation on larger cohorts of patients in the context of new therapeutic strategies.