Influence of GSTM1, GSTT1 and GSTP1 xenobiotic metabolism genes polymorphisms on treatment efficiency in patients with chronic hepatitis C

Aim. To analyze the influence of GSTT1, GSTM1 and GSTP1 genes polymorphism on treatment effectiveness in patients with chronic hepatitis C in Odessa Region using different treatment protocols. Methods. Three groups of patients with chronic hepatitis C were included. Patients of the first group (n=33) were treated with peginterferon alfa-2a and ribavirin, of the second group (n=18) - with tilorone and ribavirin, of the third group (n=26) - with silybi mariani fructuum extract. GSTT1, GSTM1 genes polymorphisms, as well as A313G polymorphism of GSTP1 gene were determined. The treatment effect was assessed by changes of biochemical parameters and viral load. Results. Patients of the first group with AG + GG genotypes had higher rate of rapid and early virologic response (73.7 and 27.3% respectively, р=0.013). Level of alanine transaminase also normalized earlier, and was significantly lower after 12 weeks of treatment in patients with AG + GG genotypes (0.57±0.28 mmol/l×h) compared to patients with АА genotype (0.99±±0.77 mmol/l×h, р=0.033). There was no influence of GSTT1 and GSTM1 genes polymorphisms on the chance of rapid and early virologic response and alanine transaminase levels. No response was found only in 4 patients with GSTT1+/GSTM1+ genotype. Conclusion. GSTT1 and GSTM1 deletion genes polymorphisms did not influence the speed of virologic response in patients with chronic hepatitis C treated with peginterferon alfa-2a and ribavirin. No virologic response in patients with chronic hepatitis C treated with peginterferon alfa-2a and ribavirin was only found in patients with GSTT1+/GSTM1+ genotype. AG + GG GSTP1 genotype was associated with more rapid alanine transaminase level normalization and rapid virologic response in patients treated with peginterferon alfa-2a and ribavirin. GSTT1+, GSTM1+ genotypes and АА genotype of GSTP1 gene are associated with better treatments results in patients treated with silybi mariani fructuum extract.