Inducible protein-10 as a predictive marker of antiviral hepatitis C treatment: A systematic review

Abstract

Aim: To investigate interferon-γ-inducible protein-10's (IP-10) potential to anticipate rapid (RVR)- and sustained virological responses (SVR) to chronic hepatitis C (CHC) treatment.

Methods: We included case series examining RVR or SVR in relation to 24 or 48 wk treatment for CHC, in patients treatment free for at least six months, with genotype 1 or 4, and in relation to 24 wk treatment for genotype 2 and 3, with pegylated interferon in combination with ribavirin. Patients had to have both a baseline IP-10 level as well as a hepatitis C virus (HCV)-RNA determination 4 wk after treatment initiation or 24 wk after end of treatment. Studies including patients with liver diseases other than CHC, human immunodeficiency virus-infection, treatment with immunosuppresents or cytostatica, alcohol dependency or active intravenous drug-use were excluded. We found 81 articles by searching the MEDLINE and EMBASE databases. Eight studies were eligible for inclusion. Their quality were assesed using an 18 point checklist for case series, developed using a modified Delphi technique. Information was extracted from the articles, and no raw data was requisitioned. The review protocol was registered at the International Prospective Register of Systematic Reviews (reg. number: CRD42014008736).

Results: Three studies reported on baseline IP-10 level in association with RVR. A signigficant association was found for HCV genotype 1 infection by two studies. Only two studies reported on HCV genotype 4 infected and genotype 2 and 3 infected patients, respectively. A trend was seen for an association between RVR and baseline IP-10 for genotype 4, while no association was found for genotype 2 and 3. Seven studies provided information regarding baseline IP-10 and SVR. Following the pattern regarding rapid virological response all five studies examining SVR in relation to baseline IP-10 levels for HCV, genotype 1 infected patients showed a significant association. Likewise a significant association was seen for HCV, genotype 4 infected, while no association was found for HCV, genotype 2 and 3 infected. Though only two studies examined the assosiation for HCV genotype 4 infected and HCV genotype 2 and 3 infected respectively.

Conclusion: We found indications of a possible association between baseline IP-10 level and virological responses in patients with CHC genotype 1 and 4.

Keywords: CXCL-10; Chemokine; Chronic hepatitis C; Genotype; Inducible protein-10’s; Interferon-γ-inducible protein-10; Pegylated interferon; Rapid virological response; Ribavirin; Sustained virological response.

Figure 1

Flow chart depicting the sorting of articles. The chart depicts the number of articles found by searching the MEDLINE and EMBASE databases 04.15.2014, the number of articles excluded during the first and second sorting, the number of duplicates, the number of articles found by manual searching references, and the number of articles excluded in the third sorting, with indication of the reason for exclusion. Articles progressing down the chart from the original search to final inclusion are marked with green boxes, articles found by manual search are marked with blue boxes, and articles excluded are marked with red boxes. SVR: Sustained virological responses; RVR: Rapid virological responses; CHC: Chronic hepatitis C; HCV: Hepatitis C virus.