SEVERITY OF CHRONIC HEPATITIS C DEPENDING ON POLYMORPHISMS OF GENES GSTT1, GSTM1 AND GSTP1
Authors: Godovan V.V.1, Ostapchuk K.V.2 1 Doctor of medical Sciences, Full Professor, Department of General and Clinical Pharmacology of Odessa State Medical University (Ukraine)
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In the 90-s of the last century came a new stage in the evolutionary approaches to drug therapy - evidence-based medicine. Its principal difference from the previous one is scientifically and clinically proven efficacy and safety, and most importantly, long-term forecasting of the impact of drug therapy on quality of life. The practice of evidence-based medicine is closely intertwined with clinical pharmacology and involves the appointment of an individual patient rational pharmacotherapy combination of individual clinical expertise and best evidence obtained through systematic research.
We studied the influence of deletion polymorphisms of genes GSTT1, GSTM1 and A313G polymorphism of gene GSTP1 on severity of chronic hepatitis C (CHC) in 77 patients. We found the patients with genotype GSTM1null had higher levels of ALT, AST and total serum bilirubin (respectively 1,98 ± 1,54 mmol/l×h, 1,08 ± 0,90 mmol/l×h, 23,6 ± 14 30 μmol/l ) than patients with genotype GSTM1 + (1,32 ± 1,02 mmol/l×h, 0,62 ± 0,50 mmol/l×h, 13,60 ± 3,50 μmol/l, p < 0,05 for all parameters). In patients with GSTM1null genotype who were infected by virus with 1b genotype, significantly more developed different stages of liver fibrosis on a Metavir scale, than in patients with genotype GSTM1 + (88,2 compared with 56,2 %, p = 0,023). We didn’t identify influence of deletion polymorphism of gene GSTT1 and A313G polymorphism of gene GSTP1 on severity of CHC.
Higher levels of ALT, AST and total serum bilirubin in CHC patients before treatment are associated with genotype GSTM1null. Patients with genotype GSTM1null, infected with genotype 1b, more likely to develop liver fibrosis varying degrees (F1-F4). Impact not identified polymorphisms of GSTT1 and GSTP1 on the severity of the CHC. Identified associations listed genes polymorphisms with the severity of the disease is the real way to customize the selection of drugs, which are aimed at improving the effectiveness and safety of treatment.
Keywords: gene polymorphisms, GSTT1, GSTM1, GSTP1, severity of chronic hepatitis C.