Table of Contents
Hepatitis Research and Treatment
Volume 2012, Article ID 619609, 4 pages
Research Article

Neopterin as a Marker of Response to Antiviral Therapy in Hepatitis C Virus Patients

1Psychiatry and Inflammation Program, Department of Psychiatry, Tufts Medical Center, Tufts University, Boston, MA 02459, USA
2Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University, Boston, MA 02459, USA
3Hepatology Clinic, Division of Gastroenterology, Department of Medicine, Tufts Medical Center, Tufts University, Boston, MA 02459, USA

Received 20 February 2012; Revised 11 April 2012; Accepted 21 April 2012

Academic Editor: Savino Bruno

Copyright © 2012 Gregory F. Oxenkrug et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Predicting the efficacy of antiviral treatment of hepatitis C virus (HCV) is of importance for both patient well-being and health care expense. The expression of interferon-stimulated genes (IFN-SGs) in the liver was suggested as a marker of response to anti-viral therapy. IFN-SGs encode the guanosine triphosphate cyclohydrolase 1 (GTPCH), a rate-limiting enzyme of pteridines biosynthesis. Neopterin, a stable byproduct of GTPCH-catalyzed reaction, is used as a marker of interferon-induced GTPCH activation. We hypothesized that assessment of neopterin concentrations might predict the response to antiviral therapy. Neopterin concentrations were evaluated in 260 HCV patients treated by pegylated interferon combined with ribavirin. Mean and median pretreatment neopterin concentrations were lower in patients with sustained virological response than in nonresponders. The rate of response was twofold higher among patients with pretreatment neopterin levels <16 nmol/L than in patients with neopterin levels ≥16 nmol/L, even after controlling for HCV genotype status. Our study suggests that the pretreatment level of neopterin might be used in routine clinical practice as rapid and cost-effective marker to predict the response to antiviral therapy in HCV patients.