Anti-E1E2 antibodies status prior therapy favors direct-acting antiviral treatment efficacy - 07/09/18
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Highlights |
• | Presence of anti-E1E2 antibody is associated with a lower baseline HCV viral load (<6log). |
• | Presence of anti-E1E2 prior DAA-treatment is a predictive factor of SVR. |
• | Absence of anti-E1E2 at baseline could predict DAA-treatment failure. |
• | Anti-E1E2 monitoring could help to optimize DAAs’ duration and re-treatment options. |
Summary |
Introduction |
Presence of anti-E1E2 antibodies was previously associated with spontaneous cure of hepatitis C virus (HCV) and predictive before treatment of a sustained virological response (SVR) to bi- or tri-therapy in naïve or experienced patients, regardless of HCV genotype. We investigated the impact of anti-E1E2 seroprevalence at baseline on treatment response in patients receiving direct-acting antiviral (DAA) therapy.
Material and methods |
We screened anti-E1E2 antibodies by ELISA in serum samples collected at treatment initiation for two groups of patients: 59 with SVR at the end of DAA treatment and 44 relapsers after DAA treatment. Nineteen patients received a combination of ribavirin (RBV) or PEG-interferon/ribavirin with sofosbuvir or daclatasvir and others received interferon-free treatment with DAA±RBV. HCV viral load was measured at different time points during treatment in a subgroup of patients.
Results |
A significant association was observed between presence of anti-E1E2 and HCV viral load<6log10 prior treatment. Among patients with anti-E1E2 at baseline, 70% achieved SVR whereas among patients without anti-E1E2, only 45% achieved SVR. Conversely, 66% of patients experiencing DAA-failure were anti-E1E2 negative at baseline. In the multivariate analysis, presence of anti-E1E2 was significantly associated with SVR after adjustment on potential cofounders such as age, sex, fibrosis stage, prior HCV treatment and alanine aminotransferase (ALT) level.
Conclusions |
The presence of anti-E1E2 at treatment initiation is a predictive factor of SVR among patients treated with DAA and more likely among patients with low initial HCV viral load (<6log10). Absence of anti-E1E2 at baseline could predict DAA-treatment failure.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatitis C, Relapse, Direct-acting antivirals, Neutralizing antibodies, Sustained virological response, E1E2 envelope
Abbreviations : HCV, DAA, SVR, RBV, PEG-IFN, SOF, DCV, BOC, TVR, GT, R, SMV, ASUNA, ELISA
Plan
Vol 42 - N° 4
P. 313-318 - septembre 2018 Retour au numéro
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