CHEMERIN IS AN INDISPENSABLE PRE-TREATMENT PREDICTOR OF SOFOSBUVIR, PEGYLATED INTERFERON-ALPHA AND RIBAVIRIN OUTCOMES IN CHRONIC HEPATITIS C EGYPTIAN PATIENTS

Chronic hepatitis C (CHC) treatment modalities dramatically evolve, however some patients still suffer treatment failure with sever aggressive side effects. Accordingly personalizing antiviral treatment becomes an urgent cornerstone in treatment path. Inflammation is one of the hallmarks of viral infection. Besides it is one of the main factors interfering with drug response. Accordingly, this study focused on studying some inflammatory markers interfering with antiviral response in different CHC patients. A cohort of 157 genotype 4 (G4) Egyptian CHC patients treated with sofosbuvir (SOF), pegylated interferon-alpha-2a (Peg-IFNα-2a) plus ribavirin (RBV) were enrolled. Single nucleotide polymorphism (SNP) within chemerin gene (rs17173608) was analyzed by quantitative real-time PCR (qRT-PCR). Serum chemerin, serum IL-6 and serum alpha-fetoprotein (AFP) were analyzed by enzyme-linked immunosorbent assay (ELISA). Fibrosis grade, serum AFP, serum IL-6 and serum chemerin levels were found to be significant univariant predictors of SOF, Peg- IFNα-2a and RBV response at (p<0.01). Moreover, G/G Chemerin (rs17173608) genotype was also proved to be associated with treatment failure (OR=17.067- 95% CI =6.684-43.575- p<0.001) in Egyptian CHC G4 patients. Combining all predictors in Multiple stepwise regression analysis concluded that higher serum chemerin levels and G/G Chemerin rs17173608 genotype formulated the strongest predictive model with a significant prediction capacity expressed by area under the receiving operating curve (AUROC) 0.881(95% CI = 0.832–0.931) with specificity of 77.1%, sensitivity of 80.2% and accuracy of 78.9%. Chemerin is a vital pretreatment predictor of anti-HCV drug response as it accurately predicts SOF, Peg- IFNα-2a and RBV different outcomes in naive Egyptian CHC G4 patients.