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Temperature increase after interferon-based HCV treatment linked to virological response

A temperature increase after a pegylated interferon injection for treating hepatitis C was associated with virological response among those with a specific IL28B polymorphism in a recent study.

In a retrospective analysis, researchers evaluated 60 treatment-naive patients with chronic HCV who were assigned peginterferon alfa-2a and ribavirin in a clinical trial. Patients’ temperatures were taken orally at baseline and once every 8 hours for 24 hours, and the maximum temperature increase from baseline (TMax) was determined. Serum HCV RNA levels, interferon-gamma-inducible-protein-10 (IP-10) and interferon-stimulated gene (ISG) expression also were measured, and genotyping was performed for the rs12979860 IL28B single nucleotide polymorphism.

Patient temperatures peaked at a median of 12.5 hours after treatment initiation, and rose by 1.2 ± 0.8°C. TMax was associated with virological decline within 72 hours of therapy, independent of sex, HCV RNA at baseline, HCV genotype and cirrhosis (r=0.59; P<.0001). Each 1 log₁₀ decline in HCV RNA was linked to a 0.49°C (95% CI, 0.31-0.67) increase.

Participants with the CC genotype had a higher TMax than those without the CC genotype (1.4 ± 0.8°C vs. 0.8 ± 0.6°C; P=.001). The association between TMax and virological decline in the initial 72 hours was observed among patients with rs12989760 CC genotype (r=0.65; P<.0001), but not with the CC/CT genotype (r=0.13; P=.53). TMax also was associated with serum IP-10 induction at 6 (r=0.6; P=.005) and 24 hours (r=0.55; P=.01) among those with the rs12989760 CC genotype.

Yaron Rotman

“The fact that fever can be used as a very early and cheap marker of treatment response … is especially important, since many patients find it difficult to complete interferon-based regimens because of the side effects,” researcher Yaron Rotman, MD, MSc, assistant clinical investigator in the Liver Diseases Branch of NIH, told Healio.com. “Physicians will be able to use our findings as a tool to encourage patients who suffer from side effects, to let them know that these actually suggest they are responding and to help convince them to persist in treatment and complete it successfully.”

Disclosure: This work was supported by the intramural research program of NIDDK.