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Original Article

Can gender predict virological response to standard antiviral

therapy for chronic hepatitis C? A retrospective study

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2
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Paola Belci , Alessandro Collo , Maria Martorana , Andrea Evangelista , Sara Giunti ,
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Roberto Gambino , Maurizio Cassader , Simona Bo , Marilena Durazzo 1
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1 Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
2 Department of Economics and Statistics “Cognetti de Martiis”, University of Turin, 10153 Turin, Italy.
ABSTRACT
Aim: The liver is a sexually dimorphic organ presenting gender differences in its metabolism, functions, enzyme activity,
membrane lipid composition and immune response. This paper aimed to assess whether gender may predict virological
response to standard antiviral therapy in subjects with chronic hepatitis C (CHC). Methods: The authors retrospectively
analyzed 100 patients with genotype 1 CHC (55 men, 45 women), who performed standard antiviral therapy (interferon and
ribavirin for 12 months) in the period 2002-2012, evaluated with blood tests and abdominal ultrasound to compare different
virological and biochemical response in both gender. Results: Rate of substained virological response (SVR) was higher,
but not significant, in women than men (46.7% vs. 34.5%, P = 0.05); difference became significant after stratification by age
(< 50 and ≥ 50 years). Specifically in the group aged under 50 years, rate of SVR was significantly higher in women than in
men (66.7% vs. 38.2%, P < 0.05). Conclusion: Female gender may predict virological response to standard antiviral therapy
in subjects with CHC aged below 50 years. Considering new potent and more expensive antiviral drugs actually available for
HCV treatment, it could be useful to identify candidates firstly eligible to therapy.

Key words: Liver; gender; antiviral therapy

Address for correspondence:
Prof. Marilena Durazzo, Department of Medical Sciences, University of Turin, C.so A.M.Dogliotti 14, 10126 Turin, Italy. E-mail: marilena.durazzo@unito.it
Received: 24-08-2015, Accepted: 04-03-2016

INTRODUCTION substances; in stress conditions, the liver produces
prevalent vasodilating substances in females than in
The liver is a sexually dimorphic organ with gender males, probably due to estrogens, contributing to
differences in gene expression, mitochondrial protect microcirculation. [1]
function, microsomal enzyme activity, membrane
lipid composition, immunological response. Many Clinical studies also showed how females are more
studies found gender differences in hepatic response susceptible to the alcohol detrimental effects,
to different stressors, postulating as pattern of as they develop liver disease following alcohol
secretion and expression of receptors of growth exposure, although reduced in quantity and time.
hormones and sex hormone levels may underlie Thus chronic alcohol assumption may modify the
sexual dimorphism. The hepatic circulation depends
by a balance between vasoconstrictor and vasodilator This is an open access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as the
Access this article online author is credited and the new creations are licensed under the identical terms.
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Website: For reprints contact: service@oaepublish.com
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How to cite this article: Belci P, Collo A, Martorana M, Evangelista
DOI: A, Giunti S, Gambino R, Cassader M, Bo S, Durazzo M. Can gender
10.20517/2394-5079.2015.53 predict virological response to standard antiviral therapy for chronic
hepatitis C? A retrospective study. Hepatoma Res 2016;2:122-30.

122 © 2016 Hepatoma Research | Published by OAE Publishing Inc.