Chronic Hepatitis C (CHC) - Genotype 3 Infection in Canada
Hepatitis C is a small RNA virus spread by blood to blood contamination. There are to date 6 known genotypes and within each there are several subtypes. Although all genotypes are distributed worldwide some are more common in certain countries and/or among certain populations.
Chronic Hepatitis C - Genotype 3
|Study Design:||Observational Model: Case-Only
Time Perspective: Prospective
|Official Title:||Demography, Clinical Characteristics, Metabolic Status, Viral Subtype and Genetics of Infection With Hepatitis C Genotype 3 in Canada|
- Factors associated with treatment outcome in genotype 3 in CHC [ Time Frame: Within 12 weeks before starting treatment compared to end of treatment response ] [ Designated as safety issue: No ]To study how factors such as viral subtype, ethnicity, insulin resistance, IL28 genotype and severity of liver disease contribute to treatment response.
Biospecimen Retention: Samples With DNA
Saliva samples will be collected for DNA extraction. Also, blood specimens will be collected for genotype subtype analysis and HOMA score calculation.
|Study Start Date:||February 2010|
|Study Completion Date:||June 2013|
|Primary Completion Date:||June 2013 (Final data collection date for primary outcome measure)|
Genotype 3(G3) infection is the predominant type in South East Asia (Bangladesh, Pakistan, India and Sri Lanka). In addition, because of the "promiscuous exposure" to hepatitis C amongst injection drug users, it is not unusual for the latter to be infected with G3 as well. There are several subtypes of G3. Viral genotype has long been recognized as a major factor influencing the response to interferon-based therapy. Patients infected with G2 and G3 respond much better to current therapy with peginterferon and ribavirin than those infected with G1 and G4. Most studies have grouped patients with G2 and G3 together, with few published comparisons of rates of viral clearance between these two favourable genotypes.
More recently it has become evident that in all individuals with chronic hepatitis C, the presence of insulin resistance, with or without the accompanying metabolic syndrome, is a major factor which influencing the response to antiviral therapy in CHC.
Very recently it has been reported and confirmed by several sites worldwide that specific polymorphisms of the IL28 gene are closely correlated with response to antiviral therapy in genotype 1 CHC. Interestingly, the polymorphisms were also shown to segregate according to ethnicity and may explain, at least in part, the marked differences in treatment response between different ethnic groups.
|University Health Network - Toronto Western Hospital|
|Toronto, Ontario, Canada, M5T 2S8|
|Toronto General Hospital - Dr. M. Sherman Liver Clinic|
|Toronto, Ontario, Canada, M5G 2C4|
|Principal Investigator:||Dr. E.J. Heathcote, MD, FRCP, FRCP(C)||University Health Network - Toronto Western Hospital|