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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Research Article

Serum Alpha-fetoprotein Levels and Response to Direct Antiviral Therapy in Patients with Chronic Hepatitis C: Real-world Results from 1716 Patients in Egypt

Author(s): Rehab Badawi, Mohamed Alboraie, Sherief Abd-Elsalam*, Mohamed Z. Abourahma, Haidi K. Ramadan, Ossama A. Ahmed, Mohamed H.A. Fouad, Shaimaa Soliman, Dina A. Mohareb, Tamer Haydara, Sherein M. Alnabawy and Mohamed El kassas

Volume 19, Issue 7, 2019

Page: [1005 - 1011] Pages: 7

DOI: 10.2174/1871530319666190204154830

Price: $65

Abstract

Background & Aims: Direct Antiretroviral Agents (DAAs), sofosbuvir-based therapies, have opened a new era in the treatment of chronic HCV infection. The aim of the study was to investigate the potential use of baseline and in serial serum, AFP levels as a predictor for response to DAAs in patients with Chronic Hepatitis C.

Methods: This multicenter observational study was carried out on 1716 chronic hepatitis C virusinfected patients who received direct anti-viral drugs for 12 weeks. The primary end point was sustained virological response at 12 weeks after the end of treatment determined by quantitative PCR for HCV RNA. Serum AFP was quantitatively assessed at baseline then after 12week after stoppage of treatment (SVR12).

Results: SVR12 rate was 97.8%. Elevated serum AFP was significantly higher in non -SVR group p value (<0.001). There was a significantly marked decrease in AFP after treatment in comparison to pretreatment values. The multivariate logistic regression analysis on the resulting significant variable from the univariate analysis revealed that only AFP was significantly related to the response to direct antiviral therapy in patients with chronic hepatitis C with p <0.001, OR 1.10 (95% CI 1.07:1.12). Other sociodemographic (e.g. Age, gender, BMI, ..) or laboratory factors (Hb, ANC, WBCs, …) did not show any significant association with the patients’ response to treatment.

Conclusions: Serum AFP levels were a predictor for response in patients with chronic HCV with the administration of direct antiviral drugs.

Keywords: HCV, treatment, predictors, response, DAAs, AFP.

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Graphical Abstract

[1]
Chu, C.W.; Hwang, S.J.; Luo, J.C.; Lai, C.R.; Tsay, S.H.; Li, C.P.; Wu, J.C.; Chang, F.Y.; Lee, S.D. Clinical, virologic, and pathologic significance of elevated serum alpha-fetoprotein levels in patients with chronic hepatitis C. J. Clin. Gastroenterol., 2001, 32(3), 240-244.
[http://dx.doi.org/10.1097/00004836-200103000-00014] [PMID: 11246354]
[2]
Greenberg, F.; Rose, E.; Alpert, E. Hereditary persistence of alpha-fetoprotein. Gastroenterology, 1990, 98(4), 1083-1085.
[http://dx.doi.org/10.1016/0016-5085(90)90037-2] [PMID: 1690155]
[3]
Johnson, P.J. The role of serum alpha-fetoprotein estimation in the diagnosis and management of hepatocellular carcinoma. Clin. Liver Dis., 2001, 5(1), 145-159.
[http://dx.doi.org/10.1016/S1089-3261(05)70158-6] [PMID: 11218912]
[4]
Tai, W.C.; Hu, T.H.; Wang, J.H.; Hung, C.H.; Lu, S.N.; Changchien, C.S.; Lee, C.M. Clinical implications of alpha-fetoprotein in chronic hepatitis C. J. Formos. Med. Assoc., 2009, 108(3), 210-218.
[http://dx.doi.org/10.1016/S0929-6646(09)60054-1] [PMID: 19293036]
[5]
Lavanchy, D. Evolving epidemiology of hepatitis C virus. Clin. Microbiol. Infect., 2011, 17(2), 107-115.
[http://dx.doi.org/10.1111/j.1469-0691.2010.03432.x] [PMID: 21091831]
[6]
Lehman, E.M.; Wilson, M.L. Epidemic hepatitis C virus infection in Egypt: estimates of past incidence and future morbidity and mortality. J. Viral Hepat., 2009, 16(9), 650-658.
[http://dx.doi.org/10.1111/j.1365-2893.2009.01115.x] [PMID: 19413698]
[7]
Ahmed, O.A.; Kaisar, H.H.; Hawash, N.; Samir, H.; Shabana, S.S.T.; Hassan, A.; Fouad, M.; Rizk, F.; Abd-Elsalam, S. Efficacy of sofosbuvir plus ribavirin with or without peginterferon-alfa in treatment of a cohort of Egyptian patients with hepatitis C virus infection. Infect. Disord. Drug Targets, 2017, 17(2), 95-100.
[http://dx.doi.org/10.2174/1871526517666170417143216] [PMID: 28413993]
[8]
Abd-Elsalam, S.; Sharaf-Eldin, M.; Soliman, S.; Elfert, A.; Badawi, R.; Ahmad, Y.K. Efficacy and safety of sofosbuvir plus ribavirin for treatment of cirrhotic patients with genotype 4 hepatitis C virus in real-life clinical practice. Arch. Virol., 2018, 163(1), 51-56.
[http://dx.doi.org/10.1007/s00705-017-3573-0] [PMID: 28983675]
[9]
Ahmed, O.A.; Kaisar, H.H.; Badawi, R.; Hawash, N.; Samir, H.; Shabana, S.S.; Fouad, M.H.A.; Rizk, F.H.; Khodeir, S.A.; Abd-Elsalam, S. Efficacy and safety of sofosbuvir-ledipasvir for treatment of a cohort of Egyptian patients with chronic hepatitis C genotype 4 infection. Infect. Drug Resist., 2018, 11, 295-298.
[http://dx.doi.org/10.2147/IDR.S153060] [PMID: 29535545]
[10]
Ahmed, O.A.; Elsebaey, M.A.; Fouad, M.H.A.; Elashry, H.; Elshafie, A.I.; Elhadidy, A.A.; Esheba, N.E.; Elnaggar, M.H.; Soliman, S.; Abd-Elsalam, S. Outcomes and predictors of treatment response with sofosbuvir plus daclatasvir with or without ribavirin in Egyptian patients with genotype 4 hepatitis C virus infection. Infect. Drug Resist., 2018, 11(11), 441-445.
[http://dx.doi.org/10.2147/IDR.S160593] [PMID: 29628768]
[11]
Thomas, D.L. Global control of hepatitis C: where challenge meets opportunity. Nat. Med., 2013, 19(7), 850-858.
[http://dx.doi.org/10.1038/nm.3184] [PMID: 23836235]
[12]
Zhang, J.; Nguyen, D.; Hu, K.Q. Chronic Hepatitis C Virus Infection: A Review of Current Direct-Acting Antiviral Treatment Strategies. N. Am. J. Med. Sci. (Boston), 2016, 9(2), 47-54.
[PMID: 27293521]
[13]
Bialecki, E.S.; Di Bisceglie, A.M. Diagnosis of hepatocellular carcinoma. HPB (Oxford), 2005, 7(1), 26-34.
[http://dx.doi.org/10.1080/13651820410024049] [PMID: 18333158]
[14]
El Raziky, M.; Attia, D. El akel, W.; Shaker, O.; Khatab, H.; Abdo, S.; Elsharkawy, A.; Esmat, G. Hepatic fibrosis and serum alpha-fetoprotein (AFP) as predictors of response to HCV treatment and factors associated with serum AFP normalization after treatment. Arab J. Gastroenterol., 2013, 14, 94-98.
[http://dx.doi.org/10.1016/j.ajg.2013.08.005] [PMID: 24206736]
[15]
Abdoul, H.; Mallet, V.; Pol, S.; Fontanet, A. Serum alpha-fetoprotein predicts treatment outcome in chronic hepatitis C patients regardless of HCV genotype. PLoS One, 2008, 3(6)e2391
[http://dx.doi.org/10.1371/journal.pone.0002391] [PMID: 18545682]
[16]
Gad, R.R.; Males, S.; El Makhzangy, H.; Shouman, S.; Hasan, A.; Attala, M.; El Hoseiny, M.; Zalata, K.; Abdel-Hamid, M.; Fontanet, A.; Mohamed, M.K.; Esmat, G. Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C. Liver Int., 2008, 28(8), 1112-1119.
[http://dx.doi.org/10.1111/j.1478-3231.2008.01750.x] [PMID: 18397226]
[17]
Abdo, A.A.; Sanai, F.M. Predictors of sustained virologic response in hepatitis C genotype 4: beyond the usual suspects. Ann. Saudi Med., 2009, 29(1), 1-3.
[http://dx.doi.org/10.4103/0256-4947.51810] [PMID: 19139625]
[18]
Males, S.; Gad, R.R.; Esmat, G.; Abobakr, H.; Anwar, M.; Rekacewicz, C.; El Hoseiny, M.; Zalata, K.; Abdel-Hamid, M.; Bedossa, P.; Pol, S.; Mohamed, M.K.; Fontanet, A. Serum alpha-foetoprotein level predicts treatment outcome in chronic hepatitis C. Antivir. Ther. (Lond.), 2007, 12(5), 797-803.
[PMID: 17713163]

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