Changes in Oral Temperature after the Initial Injection of Peginterferon Alfa-2a in Patients with Chronic Hepatitis C Reflect Host-Interferon Responsiveness
On the blog today requested by a reader is an abstract from the November meeting available @ "LiverLearning" on the AASLD web site. In this study researchers found that temperature increase *fever after the initial injection of PEG-IFN is closely associated with interferon responsiveness, and IL28B genotype. The study included 60 naive patients treating with peginterferon and ribavirin with various genotypes. 67% were genotype 1/4/6, 33% were genotype 2/3.
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Changes in Oral Temperature after the Initial Injection of Peginterferon Alfa-2a in Patients with Chronic Hepatitis C Reflect Host-Interferon Responsiveness
Topic: Health Services Research
Abstract
On the blog today requested by a reader is an abstract from the November meeting available @ "LiverLearning" on the AASLD web site. In this study researchers found that temperature increase *fever after the initial injection of PEG-IFN is closely associated with interferon responsiveness, and IL28B genotype. The study included 60 naive patients treating with peginterferon and ribavirin with various genotypes. 67% were genotype 1/4/6, 33% were genotype 2/3.
The slides from this abstract along with all abstracts, webcasts, and video podcasts are available for viewing. Free registration is required, it's quick and painless folks, start the process by clicking Here.
Once that is accomplished, sign in and come back to this post and click this link , after landing on the page click on "VIEW ePOSTER" to view the 9 slides .
Changes in Oral Temperature after the Initial Injection of Peginterferon Alfa-2a in Patients with Chronic Hepatitis C Reflect Host-Interferon Responsiveness
Topic: Health Services Research
Abstract
BACKGROUND: During the first 24 hours after the initial dose of peginterferon alfa-2a (PEG-IFN), patients have variable degrees of non-specific symptoms including fever. The significance of these side effects in reflecting the antiviral actions of PEG-IFN is unknown.
PURPOSE: To assess whether temperature change reflects interferon responsiveness as assessed by viral kinetics, serum cytokines and treatment response in patients with chronic hepatitis C.
METHODS: Previously untreated patients with chronic hepatitis C were admitted to start standard combination therapy with PEG-IFN and ribavirin. Temperatures were measured via infrared tympanic electronic thermometers in oral mode, before the first injection of PEG-IFN, and at 8, 16 and 24 hours.
Maximum temperature increase from baseline within the first 24 hours (Tmax) was determined for each patient.
Serum HCV levels were measured at baseline, 6, 24, 48, 72 hours, and weekly for the first 4 weeks of treatment. 1st phase decline of viral levels and 2nd phase slope were calculated. In a subset of patients, levels of serum interferon-gamma-inducible protein-10 (IP10) were measured by cytokine bead array assay at baseline, 6 and 24 hours after treatment initiation. The IL28B single nucleotide polymorphism, rs12979860, was genotyped using TaqMan assay.
RESULTS: Among the 60 patients enrolled (67% genotype 1/4/6, 33% genotype 2/3), oral temperature rose by 1.1± 0.8°C, reaching an average peak of 37.9±0.7°C, and rising above 38.0°C in 20 patients (33.3%). There was a strong positive correlation between Tmax and 1st phase virological decline (r2=0.35, p<0.0001), and between Tmax and IP10 fold-induction at 6 hours (n=39, r2=0.25, p=0.001) and at 24 hours (n=39, r2=0.20, p=0.004). Tmax did not correlate with 2nd phase slope. The correlation between Tmax and 1st phase decline was similar for genotype 1 (n=34, r2=0.38) and genotype 2/3 (n=20, r2=0.38) and there was no difference in Tmax between viral genotypes (p=0.38). Average Tmax was higher for patients with rs129790860 CC (1.43°C) vs. CT/TT (0.84°C, p=0.036). Tmax predicted virological response at weeks 4 (RVR, AUC=0.60) or 12 (EVR, AUC=0.61), albeit weakly.
DISCUSSION: Temperature increase after the initial injection of PEG-IFN is closely associated with interferon responsiveness, reflected by the correlation with serum IP10 increase, virological decline and IL28B genotype. The lack of difference between genotypes pinpoints its association with host-responsiveness factors. An easily measurable marker, temperature may be incorporated as a surrogate of more expensive and elaborate tests in future models of responsiveness to interferon-based treatment.
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