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MTP pattern predicted SVR in Egyptian patients with HCV genotype 4
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Microsomal triglyceride transfer protein, or MTP, could be used as a predictor for measuring sustained virologic response from antiviral therapy in Egyptian patients with hepatitis C virus genotype 4 infection, according to study data.
“Till now, (there has been) no sufficient data about correlation of MTP variants with response to therapy in HCV,” the researchers wrote. “To justify this issue, the current study aimed to determine the pattern of MTP gene polymorphisms in naive HCV genotype 4 patients to then identify the impact of MTP polymorphism on the response to combined pegylated interferon-ribavirin therapy in chronic HCV genotype 4.”
One hundred treatment-naive patients with HCV genotype 4 were recruited to receive antiviral therapy with 180 mcg of PEG-IFN alfa-2a per week and weight-based ribavirin for 48 weeks. Forty controls also were included in the study, and all 140 patients underwent DNA and laboratory testing to determine any impact of MTP polymorphism.
Of the 100 patients with HCV, 60 achieved SVR and 40 either relapsed or did not respond to treatment. MTP single nucleotide polymorphisms (SNP), such as GG, GT and TT, were predominant in patients with HCV compared with the controls (GG, 70% vs. 10%; GT, 21% vs. 87.5%; TT, 9% vs. 2.5%). Furthermore, G and T alleles also were predominant in HCV patients compared with controls (G alleles, 80.5% vs. 53.8%; T alleles, 19.5% vs. 46.3%; P=.0001 for all), according to the research.
The SNP pattern for GG was 71.7% for responders vs. 67.5% for nonresponders; for GT, 25% vs. 15%; and for TT, 3.3% vs. 17.5% (P=.038). For G alleles, the pattern was 84.2% for responders vs. 75% for nonresponders, and for T alleles, it was 15.8% vs. 25% (P=.109).
“The present study revealed that there was significant difference in the prevalence of SNPs in MTP gene between responders and nonresponders to interferon therapy of chronic hepatitis C genotype 4 patients as regards genotypes,” the researchers wrote.
Once patients were classified based on MTP gene polymorphism, researchers were able to conclude that mild to moderate fibrosis score was associated with the GG pattern of MTP polymorphism, whereas GT and TT patterns of MTP polymorphism were associated with severe fibrosis and cirrhosis (P=.0001).
Multivariate analysis showed GT genotype as an independent predictor of SVR (P=.0001), with an area under the curve of 90%, 90% sensitivity rate, 82.5% specificity and cutoff of 0.546. Fibrosis and aspartate aminotransferase levels also were predictors for antiviral treatment response for patients with HCV genotype 4.
“MTP polymorphism can be used as a marker for prediction of the response to antiviral therapy in Egyptian patients with HCV genotype 4 patients,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.