Danoprevir monotherapy decreases inflammatory markers in patients with chronic hepatitis C virus infection

Antimicrob Agents Chemother. 2011 Jul;55(7):3125-32. doi: 10.1128/AAC.00131-11. Epub 2011 Apr 18.

Abstract

Danoprevir is a potent and selective direct-acting antiviral agent that targets the protease activity of hepatitis C virus (HCV) NS3/4A. This agent results in a significant rapid decline in HCV RNA levels when it is used in monotherapy. The present study evaluated whether plasma concentrations of the inflammatory markers gamma interferon-inducible protein 10 (IP-10) and neopterin or the interferon-stimulated gene product 2'-5'-oligoadenylate synthetase (OAS-1) were correlated with the plasma HCV RNA concentration before or during 14-day danoprevir monotherapy. In contrast to pegylated interferon and ribavirin treatment, a higher baseline IP-10 concentration was positively correlated with a greater first-phase HCV RNA decline upon danoprevir administration. Changes in the IP-10 plasma concentration during danoprevir administration were also associated with categorical changes in HCV RNA concentration at days 7 and 14. The neopterin concentration appeared to be moderately decreased during danoprevir administration, although these changes were not statistically significant. However, changes in neopterin concentration showed a statistically significant correlation with changes in IP-10 concentration. Considerable variation in the OAS-1 concentration was observed before and during treatment, including in patients treated with placebo and/or patients with minimal virologic response. Overall, these results suggest that effective treatment with a direct-acting antiviral agent may reduce hepatic inflammation and that first-phase HCV RNA decline during treatment with an NS3/4A protease inhibitor is more robust in patients with high baseline IP-10 concentrations.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2',5'-Oligoadenylate Synthetase / blood
  • Antiviral Agents / therapeutic use*
  • Chemokine CXCL10 / blood
  • Cyclopropanes
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / genetics
  • Hepatitis C, Chronic / immunology
  • Humans
  • Inflammation / blood*
  • Inflammation / drug therapy*
  • Inflammation / immunology
  • Isoindoles
  • Lactams / therapeutic use*
  • Lactams, Macrocyclic
  • Liver / drug effects
  • Liver / metabolism
  • Liver / virology
  • Neopterin / blood
  • Proline / analogs & derivatives
  • RNA, Viral / blood
  • Sulfonamides / therapeutic use*

Substances

  • Antiviral Agents
  • CXCL10 protein, human
  • Chemokine CXCL10
  • Cyclopropanes
  • Isoindoles
  • Lactams
  • Lactams, Macrocyclic
  • RNA, Viral
  • Sulfonamides
  • Neopterin
  • danoprevir
  • Proline
  • OAS1 protein, human
  • 2',5'-Oligoadenylate Synthetase