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Sheu T, Milgrom S, Dabaja B, Andraos T, Chi L, Nastoupil L, Fowler N, Westin J, Neelapu S, Lee H, Hagemeister F, Oki Y, Fanale M, Fayad L, Turturro F, Samaniego F, Pinnix C. Consolidative Radiation Dose De-escalation in Primary CNS Lymphoma for Patients with an Incomplete Response to Methotrexate Based Chemotherapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schuster S, Bishop M, Tam C, Waller E, Borchmann P, Mcguirk J, Jäger U, Jaglowski S, Andreadis C, Westin J, Fleury I, Bachanova V, Foley S, Ho P, Mielke S, Holte H, Anak O, Pacaud L, Awasthi R, Tai F, Salles G, Maziarz R. GLOBAL PIVOTAL PHASE 2 TRIAL OF THE CD19-TARGETED THERAPY CTL019 IN ADULT PATIENTS WITH RELAPSED OR REFRACTORY (R/R) DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)-AN INTERIM ANALYSIS. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_6] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Wang M, Lee H, Thirumurthi S, Chuang H, Hagemeister F, Westin J, Fayad L, Samaniego F, Turturro F, Chen W, Oriabure O, Feng L, Zhou S, Huang S, Li S, Zhang L, Badillo M, Wu L, Ahmed M, Yan F, Nomie K, Lam L, Addison A, Romaguera J. IBRUTINIB-RITUXIMAB FOLLOWED BY REDUCED CHEMO-IMMUNOTHERAPY CONSOLIDATION IN YOUNG, NEWLY DIAGNOSED MANTLE CELL LYMPHOMA PATIENTS: a WINDOW OF OPPORTUNITY TO REDUCE CHEMO. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Westin J, Fayad L, Oki Y, Nastoupil L, Hagemeister F, Turturro F, Lee H, Rodriguez A, Young K, McDonnell T, Ford R, Neelapu S, Davis R. RITUXIMAB, LENALIDOMIDE, AND IBRUTINIB ALONE AND COMBINED WITH CHEMOTHERAPY FOR PATIENTS WITH NEWLY DIAGNOSED DIFFUSE LARGE B-CELL LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nastoupil L, Westin J, Fowler N, Fanale M, Samaniego F, Oki Y, Obi C, Cao J, Cheng X, Ma M, Wang Z, Chu F, Feng L, Zhou S, Davis R, Neelapu S. HIGH RESPONSE RATES WITH PEMBROLIZUMAB IN COMBINATION WITH RITUXIMAB IN PATIENTS WITH RELAPSED FOLLICULAR LYMPHOMA: INTERIM RESULTS OF AN ON OPEN-LABEL, PHASE II STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chaudhry M, Nastoupil L, Samaniego F, Neelapu S, Hagemeister F, Fanale M, Fayad L, Westin J, Oki Y, Feng L, Fowler N. TREATMENT WITH COMBINATION OF LENALIDOMIDE AND RITUXIMAB ACHIEVES DURABLE RESPONSES IN A LONG TERM FOLLOW UP OF PATIENTS WITH INDOLENT NON-HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Casasnovas R, Westin J, Thieblemont C, Zijlstra J, Hill B, De La Cruz Vicente F, Choquet S, Caimi P, Kaplan J, Canales M, Kuruvilla J, Follows G, van den Neste E, Meade J, Wrigley B, Devlin M, Saint-Martin J, Nippgen C, Gardner H, Shacham S, Kauffman M, Maerevoet M. A PHASE 2B RANDOMIZED STUDY OF SINGLE AGENT SELINEXOR IN PATIENTS WITH RELAPSED/REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fowler N, Samaniego F, Turturro F, Neelapu S, Forbes S, Westin J, Fayad L, Fanale M, Feng L, Arafat J, Neal E, Hagemeister F, Nastoupil L. THE IMMUNOLOGIC DOUBLET OF LENALIDOMIDE PLUS OBINUTUZUMAB IS HIGHLY ACTIVE IN RELAPSED/REFRACTORY FOLLICULAR LYMPHOMA, RESULTS OF A PHASE I/II STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Westin J, Oki Y, Nastoupil L, Fayad L, Neelapu S, Turturro F, Hagemeister F, Rodriguez A, Lee H, Young K, McDonnell T, Ford R, Davis R. LENALIDOMIDE AND OBINUTUZUMAB WITH CHOP FOR NEWLY DIAGNOSED DIFFUSE LARGE B-CELL LYMPHOMA: PHASE I/II RESULTS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bjarnason A, Lindh M, Westin J, Andersson LM, Baldursson O, Kristinsson KG, Gottfredsson M. Utility of oropharyngeal real-time PCR for S. pneumoniae and H. influenzae for diagnosis of pneumonia in adults. Eur J Clin Microbiol Infect Dis 2017; 36:529-536. [PMID: 27822652 PMCID: PMC5309271 DOI: 10.1007/s10096-016-2829-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/20/2016] [Indexed: 12/11/2022]
Abstract
A lack of sensitive tests and difficulties obtaining representative samples contribute to the challenge in identifying etiology in pneumonia. Upper respiratory tract swabs can be easily collected and analyzed with real-time PCR (rtPCR). Common pathogens such as S. pneumoniae and H. influenzae can both colonize and infect the respiratory tract, complicating the interpretation of positive results. Oropharyngeal swabs were collected (n = 239) prospectively from adults admitted to hospital with pneumonia. Analysis with rtPCR targeting S. pneumoniae and H. influenzae was performed and results compared with sputum cultures, blood cultures, and urine antigen testing for S. pneumoniae. Different Ct cutoff values were applied to positive tests to discern colonization from infection. Comparing rtPCR with conventional testing for S. pneumoniae in patients with all tests available (n = 57) resulted in: sensitivity 87 %, specificity 79 %, PPV 59 % and NPV 94 %, and for H. influenzae (n = 67): sensitivity 75 %, specificity 80 %, PPV 45 % and NPV 94 %. When patients with prior antimicrobial exposure were excluded sensitivity improved: 92 % for S. pneumoniae and 80 % for H. influenzae. Receiver operating characteristic curve analysis demonstrated for S. pneumoniae: AUC = 0.65 (95 % CI 0.51-0.80) and for H. influenzae: AUC = 0.86 (95 % CI 0.72-1.00). Analysis of oropharyngeal swabs using rtPCR proved both reasonably sensitive and specific for diagnosing pneumonia caused by S. pneumoniae and H. influenzae. This method may be a useful diagnostic adjunct to other methods and of special value in patients unable to provide representative lower airway samples.
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Janku F, Vergilio J, Salhia B, Fanale M, Oki Y, Huang H, Westin J, He J, Nahas M, Mughal T, Miller V, Stephens P, Raina A, Garrido-Laguna I, Meric-Bernstam F, Ross J, Liang W. Comprehensive genomic profiling reveals recurrent XPO1 mutations and other alterations in archival samples of patients with Hodgkin lymphoma. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gustavsson L, Nordén R, Letelier Molnegren V, Lindh M, Westin J, Andersson LM. Longer duration of viral shedding following infection with a novel norovirus GII.4 strain. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Braide I, Westin J, Hasselbalch H, Hippe E, Lisse I, Röckert L, Swolin B, Zador G. Demonstrated Benefit of Continuous Interferon-Alpha-2b Therapy in Hairy Cell Leukemia. A Two-Year Follow-Up. Leuk Lymphoma 2016; 5:23-31. [PMID: 27463206 DOI: 10.3109/10428199109068101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interferon-alpha-2b (IFN) was given to a series of 50 patients with hairy cell leukemia (HCL). The IFN dose for both induction and maintenance was 2.0 × 10(6) IU/m(2) s.c. three times weekly. At 24 months 38 patients remained in the study. The proportion of complete responders (CR) increased during the follow-up, and had at 24 months reached 58%, while 28% at the same time had a partial (PR) and 14% a minor response (MR). During the two years of continuous IFN treatment none of the 38 patients showed any signs of relapse. The response rate was similar between splenectomized (n = 15) and non-splenectomized (n = 23) patients, but the rise in platelets was much steeper and reached a significantly higher plateau in patients, who previously had undergone splenectomy. The IFN therapy was generally well tolerated, but when evaluated at 24 months at least some (mostly mild) toxicity was noted in 76% of the patients. None of the patients developed neutralizing antibodies to IFN.
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Magnusson J, Norder H, Riise GC, Andersson LM, Brittain-Long R, Westin J. Incidence of Hepatitis E Antibodies in Swedish Lung Transplant Recipients. Transplant Proc 2016; 47:1972-6. [PMID: 26293083 DOI: 10.1016/j.transproceed.2015.04.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/07/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hepatitis E virus (HEV) is an important cause of acute and chronic hepatitis in solid organ transplant recipients, especially liver transplant recipients. However, less is known of the incidence and prevalence of HEV in lung transplant recipients. METHODS In a prospective study, 62 patients were observed during the first year after lung transplantation. Sera were analyzed for anti-HEV immunoglobulin G (IgG) and IgM at 12 months after transplantation. Samples positive for anti-HEV were also analyzed for HEV RNA by polymerase chain reaction. Pretransplantation samples were analyzed for patients with detectable anti-HEV 1 year after transplantation. RESULTS Eight patients (13%) had anti-HEV IgG at the 12-month follow-up sample. HEV RNA could not be detected in any of these samples. One of these patients seroconverted during the follow-up without developing acute or chronic hepatitis. CONCLUSIONS Our results show that the prevalence of HEV antibodies among Swedish lung transplant recipients is similar when compared to the general population. It also suggests that the risk for HEV antibody seroconversion during first year is limited.
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Laubach J, Garderet L, Mahindra A, Gahrton G, Caers J, Sezer O, Voorhees P, Leleu X, Johnsen HE, Streetly M, Jurczyszyn A, Ludwig H, Mellqvist UH, Chng WJ, Pilarski L, Einsele H, Hou J, Turesson I, Zamagni E, Chim CS, Mazumder A, Westin J, Lu J, Reiman T, Kristinsson S, Joshua D, Roussel M, O'Gorman P, Terpos E, McCarthy P, Dimopoulos M, Moreau P, Orlowski RZ, Miguel JS, Anderson KC, Palumbo A, Kumar S, Rajkumar V, Durie B, Richardson PG. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group. Leukemia 2015; 30:1005-17. [DOI: 10.1038/leu.2015.356] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/11/2015] [Accepted: 09/24/2015] [Indexed: 11/09/2022]
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Pinnix C, Dabaja B, Milgrom S, Smith G, Reed V, Arzu I, Westin J, Rondon G, Hosing C, Nieto Y, Ahmed S. Salvage Radiation Therapy Prior to Stem Cell Transplantation for Chemorefractory B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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42
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Gustavsson L, Westin J, Lindh M, Andersson LM. Faecal viral load does not predict short-term mortality in norovirus infection. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tao R, Shihadeh F, Pinnix C, Arzu I, Reed V, Oki Y, Westin J, Fayad L, Medeiros L, Rodriguez A, Dabaja B. Does Skeletal Presentation Make a Difference in Outcomes of Diffuse Large B-cell Lymphoma? A Review of the 25-Year Experience With Treating Primary Bone Lymphoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pinnix C, Westin J, Ahmed M, Reed V, Romaguerra J, Oki Y, Rodriguez M, Fayad L, Hagemeister F, Kwak L, Medeiros L, Francesco T, Davis R, Chuang H, Davis R, Dabaja B. The Role of Radiation Therapy in the Treatment of Primary Mediastinal B Cell Lymphoma Treated with Rituximab containing Regimens. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Janku F, Garrido-Laguna I, Velez-Bravo V, Falchook G, Subbiah V, Hong D, Oki Y, Westin J, Nunez C, Fayad L, Kwak L, Neelapu S, Shpall E, Wheler J, Lang W, Salhia B, Meric-Bernstam F, Kurzrock R, Fanale M. Significant Activity of the mTOR Inhibitor Sirolimus and HDAC Inhibitor Vorinostat in Heavily Pretreated Refractory Hodgkin Lymphoma Patients. KLINISCHE PADIATRIE 2014. [DOI: 10.1055/s-0034-1371153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lindh M, Arnholm B, Björkman P, Hellstrand K, Lagging M, Nilsson S, Wahlberg T, Wallmark E, Weiland O, Wejstål R, Westin J, Widell A, Norkrans G. Dynamic tailoring of treatment durations improves efficiency of hepatitis C treatment with pegylated interferon and ribavirin. J Viral Hepat 2013; 20:e82-9. [PMID: 23490394 DOI: 10.1111/jvh.12014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 08/01/2012] [Indexed: 12/09/2022]
Abstract
The treatment durations for hepatitis C are guided by the analysis of hepatitis C virus (HCV) RNA in blood at certain time points. This multicentre, randomized open label trial evaluated the utility and performance of individualized treatment durations guided by viral decline rates in 103 patients with HCV genotype 1 infection. Pegylated interferon 2a and ribavirin were given as standard of care (SOC) for 24, 48 or 72 weeks or as dynamic treatment (DT) for 24-72 weeks. The DT duration was based on the time point when log HCV RNA would reach 0 log copies/mL, as estimated by the second-phase decline. The rate of sustained virologic response was 63% for SOC and 54% for DT, but this difference was not significant in multiple regression analysis taking predictive factors such as interleukin-28B genotypes, age and baseline viremia into account (P = 0.45). The mean required treatment time per cured patient was 51 weeks for DT as compared with 58 weeks for SOC (P = 0.22) when given per protocol (n = 95) and was significantly shorter (42 vs 51 weeks) among patients who achieved undetectable HCV RNA (P = 0.01). We conclude that DT was feasible and increased efficiency. The estimated time point for 0 log viral copies/mL is a new and quantitative response variable, which may be used as a complement to the qualitative variable rapid virologic response. The outcome parameter treatment weeks per cured patient could become a useful tool for comparing treatment efficiency also in the era of directly acting antivirals.
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Sansone M, Andersson M, Brittain-Long R, Andersson LM, Olofsson S, Westin J, Lindh M. Rhinovirus infections in western Sweden: a four-year molecular epidemiology study comparing local and globally appearing types. Eur J Clin Microbiol Infect Dis 2013; 32:947-54. [PMID: 23435753 PMCID: PMC7087832 DOI: 10.1007/s10096-013-1832-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 01/24/2013] [Indexed: 11/07/2022]
Abstract
Human rhinovirus (HRV) is a highly prevalent pathogen and a major cause of acute respiratory tract infection (ARTI). HRV express less seasonality than other viral ARTIs, which typically appear as seasonal epidemics lasting for 1–2 months. The aim of this study was to investigate the seasonal patterns of HRV types over four consecutive years in one geographic region. HRV identified in respiratory samples from 114 patients over a four-year period were analysed by VP4/VP2 sequencing. HRV-A was found in 64, HRV-B in 11 and HRV-C in 37 cases. Overall, 33 different HRV-A types, nine B types and 21 C types were found. As many as 21 of the HRV types appeared during several seasons, with a maximum time-span of four years. Some types appeared during successive seasons and, in some cases, phylogenetic analysis indicated extended periods of circulation locally. Most of the strains were closely related to HRV identified in other parts of the world during the same time period. HRV strains that circulate locally represent many types and seem to reflect that HRV infections are highly globalised. The existence of simultaneous or successive epidemics with different HRV types in combination with the ability of each type to remain in the local population over extended periods of time may contribute to explaining the high rate of HRV infections.
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Guedj H, Guedj J, Negro F, Lagging M, Westin J, Bochud PY, Bibert S, Neumann AU. The impact of fibrosis and steatosis on early viral kinetics in HCV genotype 1-infected patients treated with Peg-IFN-alfa-2a and ribavirin. J Viral Hepat 2012. [PMID: 22676361 DOI: 10.1111/j.1365-2893.2011.01569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hepatitis C viral (HCV) kinetics after initiation of interferon-based therapy provide valuable insights for understanding virus pathogenesis, evaluating treatment antiviral effectiveness and predicting treatment outcome. Adverse effects of liver fibrosis and steatosis on sustained virological response have been frequently reported, yet their impacts on the early viral kinetics remain unclear. In this study, associations between histology status and early viral kinetics were assessed in 149 HCV genotype 1-infected patients treated with pegylated interferon alfa-2a and ribavirin (DITTO trial). In multivariate analyses adjusted for critical factors such as IL28B genotype and baseline viral load, presence of significant fibrosis (Ishak stage > 2) was found to independently reduce the odds of achieving an initial reduction (calculated from day 0 to day 4) in HCV RNA of ≥2 logIU/mL (adjusted OR 0.03, P = 0.004) but was not associated with the second-phase slope of viral decline (calculated from day 8 to day 29). On the contrary, presence of liver steatosis was an independent risk factor for not having a rapid second-phase slope, that is, ≥0.3 logIU/mL/week (adjusted OR 0.22, P = 0.012) but was not associated with the first-phase decline. Viral kinetic modelling theory suggests that significant fibrosis primarily impairs the treatment antiviral effectiveness in blocking viral production by infected cells, whereas the presence of steatosis is associated with a lower net loss of infected cells. Further studies will be necessary to identify the biological mechanisms underlain by these findings.
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Guedj H, Guedj J, Negro F, Lagging M, Westin J, Bochud PY, Bibert S, Neumann AU. The impact of fibrosis and steatosis on early viral kinetics in HCV genotype 1-infected patients treated with Peg-IFN-alfa-2a and ribavirin. J Viral Hepat 2012; 19:488-96. [PMID: 22676361 DOI: 10.1111/j.1365-2893.2011.01569.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Hepatitis C viral (HCV) kinetics after initiation of interferon-based therapy provide valuable insights for understanding virus pathogenesis, evaluating treatment antiviral effectiveness and predicting treatment outcome. Adverse effects of liver fibrosis and steatosis on sustained virological response have been frequently reported, yet their impacts on the early viral kinetics remain unclear. In this study, associations between histology status and early viral kinetics were assessed in 149 HCV genotype 1-infected patients treated with pegylated interferon alfa-2a and ribavirin (DITTO trial). In multivariate analyses adjusted for critical factors such as IL28B genotype and baseline viral load, presence of significant fibrosis (Ishak stage > 2) was found to independently reduce the odds of achieving an initial reduction (calculated from day 0 to day 4) in HCV RNA of ≥2 logIU/mL (adjusted OR 0.03, P = 0.004) but was not associated with the second-phase slope of viral decline (calculated from day 8 to day 29). On the contrary, presence of liver steatosis was an independent risk factor for not having a rapid second-phase slope, that is, ≥0.3 logIU/mL/week (adjusted OR 0.22, P = 0.012) but was not associated with the first-phase decline. Viral kinetic modelling theory suggests that significant fibrosis primarily impairs the treatment antiviral effectiveness in blocking viral production by infected cells, whereas the presence of steatosis is associated with a lower net loss of infected cells. Further studies will be necessary to identify the biological mechanisms underlain by these findings.
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Alsiö Å, Jannesson A, Langeland N, Pedersen C, Färkkilä M, Buhl MR, Mørch K, Westin J, Hellstrand K, Norkrans G, Lagging M. Early quantification of HCV core antigen may help to determine the duration of therapy for chronic genotype 2 or 3 HCV infection. Eur J Clin Microbiol Infect Dis 2011; 31:1631-5. [DOI: 10.1007/s10096-011-1486-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 11/03/2011] [Indexed: 10/15/2022]
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