Direct-acting antiviral-based triple therapy on alpha-fetoprotein level in chronic hepatitis C patients

作者：Takayama Koji; Furusyo Norihiro^*; Ogawa Eiichi; Ikezaki Hiroaki; Shimizu Motohiro; Murata Masayuki; Hayashi Jun

来源：World Journal of Gastroenterology, 2015, 21(15): 4696-4706.

DOI：10.3748/wjg.v21.i15.4696

• Chronic hepatitis C
• Direct-acting antiviral agents
• Hepatocellular carcinoma
• Serum alpha-fetoprotein
• Telaprevir

AIM: To investigate the impact of telaprevir-based triple therapy on the serum alpha-fetoprotein (AFP) level of chronic hepatitis C patients.
METHODS: A total of 210 patients with chronic hepatitis C genotype 1 of high viral load (baseline serum hepatitis C virus RNA > 5.0 log(10) IU/mL) were divided into two groups by type of treatment: triple therapy with telaprevir, pegylated-interferon-alpha (PEG-IFN alpha), and ribavirin (RBV) for 24 wk (n = 88), or dual therapy with PEG-IFN alpha and RBV for 48 wk (n = 122). The relationship between virological response and the change in the serum AFP level from baseline to 24 wk after the end of treatment was examined.
RESULTS: No significant difference in mean baseline AFP level was found between the triple and dual therapy groups (8.8 ng/mL vs 7.8 ng/mL). Triple therapy produced significant declines in the AFP level in sustained virological response (SVR) and non-SVR patients (7.8 ng/mL at baseline to 3.5 ng/mL at 24 wk after the end of treatment, P < 0.001 and 14.3 ng/mL to 9.5 ng/mL, P = 0.004, respectively). In contrast, dual therapy resulted in a significant decline in AFP level only in SVR patients (4.7 ng/mL to 2.8 ng/mL, P < 0.001), but not in non-SVR patients (10.2 ng/mL to 10.1 ng/mL). Among patients with a high-baseline AFP level (>= 10 ng/mL), the decline in the AFP level was significantly higher in the triple therapy than in the dual therapy group (15.9 ng/mL vs 1.6 ng/mL, P = 0.037).
CONCLUSION: Regardless of virological response, telaprevir-based triple therapy reduced the serum AFP level.

• 出版日期2015-4-21