John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Can we predict early response to treatment? Volume 17, supplement 5, novembre 2010

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Service d'hépatologie, INSERM U773 CRB3, Hôpital Beaujon, 100 Bvd du gal Leclerc, 92118 Clichy cedex

Because of the important side effects and high cost of PEG-IFN plus ribavirin therapy, it is highly important to identify markers that can discriminate patients who will not respond to the treatment. Several viral and host factors have been associated with non-response: steatosis, obesity, insulin resistance, age, male sex, ethnicity and genotypes. Many studies have demonstrated that in non-responders, some interferon-stimulated genes were upregulated before treatment. Patients who present a rapid virological response (RV have a greater chance of achieving an SVR (higher than 85%). Patients who do not present any decrease of the viral load will not be able to respond to the treatment. Very consistent data were reported by independent groups finding SNPs near the IL-28B (IFN-3k) region and associated with treatment response, thus opening a window for personalized medicine Those findings associated to clinical, biochemical and histological data may help detect responders before starting any treatment. This is a very important issue because the standard treatment is physically and economically demanding. The future of HCV treatment would probably consist in the addition of specifically targeted antiviral therapy for HCV such as protease and/or polymerase inhibitors to the standard of care.