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hormonal balance in both sexes, suggesting a role (ALP), total and fractionated bilirubin, alpha-
for sex hormones in the pathogenesis of alcohol- fetoprotein, INR, creatinine, uric acid, cryoglobulins,
induced liver disease. Furthermore, compared to thyroid hormones, ferritin, HBV serum profile
men, women have a lower volume of distribution and HCV-RNA], abdominal ultrasound and fibrosis
and gastric alcohol dehydrogenase activity, so being assessment.
[2]
more prone to liver injury. Furthermore, gender
differences have been reported in both incidence Specific anti-HCV antibodies were assessed by
and progression of specific liver diseases, such as chemiluminescence (“chemioluminescent assay”,
autoimmune hepatitis, genetic hemochromatosis, Architect, Abbott Laboratories, AbbottPark, IL). [3,4]
non-alcoholic hepatic steatosis and chronic hepatitis
C (CHC). Qualitative and quantitative assessment of HCV
RNA were performed using the “COBAS Amplicor
In this study, we aimed to assess whether gender HCV system” (sensitivity 50 IU/mL, Roche Molecular
may predict virological response to standard antiviral Systems, INC., Branchburg, NJ) and the bDNA signal
therapy in subjects with CHC. The identification of amplification test (sensitivity 615 IU/mL, Branched-
predictive factors for response to treatment may DNA version 3.0, Bayer Diagnostics Corporation,
allow personalize therapy and improve the cost- Tarritown, NY), respectively, in the period 2002-
effectiveness profile. 2007, and the qualiquantitative method COBAS
AmpliPrepTM-COBAS TaqManTM (CAP/CTM HCV;
METHODS sensitivity 15 IU/mL) since 2008. [5-8]

Patients Both HCV RNA genotype and subtype were assessed
We retrospectively evaluated 100 subjects (55 men, by reverse hybridization line probe assay (INNO-LIPA,
[9]
45 women) with genotype 1 CHC who performed Innogenetics, Ghent, Belgium).
standard antiviral therapy [interferon (IFN) and Hepatic steatosis, assessed by ultrasound,
ribavirin for 12 months] in the period 2002-2012, was defined as an increased liver parenchyma
followed by the Department of Medical Science echogenicity compared to the spleen or to the right
of “San Giovanni Battista” hospital-Turin (Italy). kidney, the attenuation of the ultrasound beam in
Criteria to start therapy were: serum alanine depth tissues and the loss of echoes in the portal
aminotransferase (ALT) levels 1.2 times the upper veins walls according to the following grade scoring
limit of the normal range in at least two assessments system: grade 0, normal echogenicity, absence of
during the previous 6 months; anti-hepatitis C virus differences between echogenicity of liver and kidney;
(HCV) antibody positivity; positive polymerase chain grade 1, mild steatosis with increased echogenicity
reaction for HCV-RNA; hemoglobin values >13 g/dL of liver compared to kidney, absence of attenuation
in males and > 12 g/dL in females, leukocytes count of the ultrasound beam, possibility to explore the
> 3,000 cells/mm , platelets (PLTs) count > 100,000 depth of hepatic parenchyma; grade 2, moderate
3
cells/mm , normal serum bilirubin, international increase of steatosis with higher echogenicity of the
3
normalized ratio (INR) and thyroid function tests. liver, attenuation of ultrasound beam in depth, loss
of echoes from the peripheral portal branches; and
Exclusion criteria included previous antiviral grade 3, advanced steatosis with marked increase
treatments for CHC; co-infections with hepatitis in echogenicity, attenuation of ultrasound beam
B virus (HBV) or human immunodeficiency virus; in depth and loss of echoes from the major portal
immunosuppression state; autoimmune hepatitis; branches.
primary biliary cirrhosis; chronic alcohol abuse;
uncontrolled psychiatric illness; decompensated Fibrosis was assessed by elastography (FibroScan
cirrhosis; chronic kidney failure; heart disease; elastography) and defined as follows: F0 (up to 5
hepatocellular carcinoma; pregnancy. KPa), F1 (5 to 8.9 KPa), F2 (8.9 to 11 KPa), F3 (11 to
14.5 KPa), F4 (> 14.5 KPa ). [10]
Laboratory analyses and instrumental evaluations
Before treatment, patients underwent routine blood In subjects not underwent to FibroScan (n = 33,
tests [including assessment of complete blood count, males = 18), fibrosis was estimated by the FIB-4
aspartate aminotransferase (AST), ALT, gamma- method, according to the formula: [age (years) ×
glutamyltransferase (GGT), alkaline phosphatase AST (U/L)] / PLTs (10 /L) × [ALT (U/L)] and defined
½
9
Hepatoma Research | Volume 2 | May 6, 2016 123