Clinical features of chronic hepatitis C and efficacy of antiviral treatment in Caucasian and Mongoloid patients

Aim. To present the comparative clinical characteristics of chronic hepatitis C infection and to estimate the effect of antiviral treatment in Caucasian and Mongoloid patients, considering interleukin-28B gene polymorphism in study populations.

Methods. Population and genetic study including 1520 healthy subjects and 267 patients with chronic viral hepatitis of Caucasian and Mongoloid race analyzed interleukin-28B gene polymorphism. 433 patients with chronic viral hepatitis C were followed up. Combined antiviral treatment by pegylated interferon alfa-2a and ribavirin was administered for 48 weeks. The rates of early and sustained virologic response were the endpoints for assessing antiviral treatment effect. 82 Caucasian patients and 42 Mongoloid patients have completed the full course of antiviral treatment and 24 weeks of follow-up.

Results. The following clinical features of chronic hepatitis C were revealed in Mongoloids: more extensive liver fibrosis, older age, longer infection duration and higher total cholesterol levels (due to triglycerides). These factors negate the expected better effect of antiviral therapy effect, associated with higher prevalence of interleukin-28B favorable genotypes in Mongolian population. The presence of the C-allele of rs12979860 gene and T-allele of rs8099917 gene reaches 89.6 and 91.7% respectively in Mongolian population, which is comparable with those in China, Japan and Korea, and is typical for the whole of Asia. Combined treatment with pegylated interferon alfa-2a and ribavirin in patients with genotype 1 of hepatitis C virus led to sustained virologic response in 78.5% of Mongoloid and in 56.1% of Caucasian patients; groups were totally comparable.

Conclusion. Mongoloid patients with chronic hepatitis C reached sustained virologic response to antiviral treatment with pegylated interferon and ribavirin significantly more frequently compared to Caucasians, in cases of no aggravating factors and minimal liver fibrosis.