Method to detect substitutions in the interferon-sensitivity-determining region of hepatitis C virus 1b for prediction of response to interferon therapy

Substitutions deduced by direct sequencing in the interferon-sensitivity- d etermining region (ISDR) of hepatitis C virus (HCV) are related to patients ' responses to interferon (IFN), but sequencing is time consuming and resul ts are only for the dominant virus, We developed a rapid method to detect s uch changes. With serum from 50 patients with chronic hepatitis C (genotype 1b) given IFN-alpha, a way to detect changes in ISDR by hybridization with oligonucleotide probes that had a prototype nucleotide sequence of HCV-J w as established. Hybridization intensity was expressed as optical density (O DNS5A) The method was checked with serum from 100 more patients. In the stu dy of 50 patients, all 21 with the prototype sequences had a high ODNS5A (g reater than or equal to0.4), and all 8 patients with a mutant-type sequence had low values (less than or equal to0.2). Twelve (95% confidence interval , 36-81%) of 20 patients with ODNS5A Of <0.4 and 2 (1%-22%) of 30 patients with ODNS5A <greater than or equal to>0.4 had complete responses (CR), All nine (66%-100%) patients with ODNS5A <0.4 and little HCV RNA (<100 kIU/mL) had CR, but none (0%-14%) of the 24 patients with high values from both pre dictors had CR, In the study of 100 patients, ODNS5A and the HCV RNA level were independent predictors of the effects of IFN. By multivariate analysis , the odds ratio for a CR in patients with ODNS5A of greater than or equal to0.4 was 0.015 (0.001-0.190) compared with the other patients (P = .001). In conclusion, our method should be useful in identification of prototype s trains, which generally resist IFN therapy.