onders; SVR, sustained viral response; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase, Alb, albumin; T. Bil, total bilirubin; D. Bil, direct bilirubin, AFP, alphafetoprotin; TLC, total leucocyte count; a b c Hg, haemoglobin Significant difference from normal control group; Significant difference from NR group; Significant difference from SVR group. doi:10.1371/journal.pone.0121524.t001 5 / 12 MicroRNAs as Predictor Markers for Response to Treatment in HCV miR-122, miR-221, and miR-21 expression levels in HCV-4 patients and normal controls The data presented in Fig. 1 demonstrate that there was a highly significant increase in the quantitative expression levels of miR-122, miR-221 and miR-21 in all HCV-4 patients compared with the normal control group. However, although there was no significant difference in miR-221 quantitative expression between the NR and SVR groups, there was a significant difference in the quantitative expression of miR-21 and miR-122. Correlation between miR-122, miR-221 and miR-21 and viral load To further verify the correlation between the expression levels of miR-122, miR-221 and miR21 with viral load among the HCV-4 cases, multivariate logistic regression analysis with Walds test was used. As shown in Fig. 2, log HCV PCR showed a significant inverse correlation with miR-21 and miR-122 quantitative expression levels in HCV-4 patients. However, 
there was no significant correlation between log HCV PCR and miR-221 quantitative expression levels despite the highly significant difference between the control group and HCV-4 patients in the mean value of miRNA-221. Measurement of the power of miR-122, miR-221 and miR-21 to predict drug responses in HCV-4 patients Multiple logistic regression analysis was performed to determine whether the miRNA markers could predict the drug response in HCV-4 patients. Fig 1. Real-time qPCR of miR-122, miR-221, miR-21 expression levels. Each column represents the relative amount of miRNAs normalised to the expression of the normal control. The data shown are mean SE. of the three independent experiments. a: indicates a significant difference from the normal control group; b: indicates a significant difference from NR; c: indicates a significant difference from SVR at P < 0.05. doi:10.1371/journal.pone.0121524.g001 6 / 12 MicroRNAs PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19761586 as Predictor Markers for Response to Treatment in HCV Fig 2. Correlation between log HCV PCR and miR-21, miR-122, and miR-221 in patients with HCV-4. Points represent 2-t values for miRNAs normalised to normal controls. Difference was considered significant at P < 0.05. doi:10.1371/journal.pone.0121524.g002 studied diagnostic markers. Fig. 3 represents a ROC curve for the prediction of the drug response among HCV-4 cases by the quantitative expression of miR-21 and miR-221. The sensitivity and specificity of miR-21 INK1117 calculated in this study were 82.2% and 77.3%, respectively, with a cut-off value of 1.7 and a positive predictive value of 88.1%. The sensitivity and specificity PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19763404 of miR-122 were 68.9% and 59.1%, respectively, with a cut-off value of 3.5 and a positive predictive value of 77.5%. Finally, the sensitivity and specificity of combined miR-21 and miR-122 quantitative expression calculated in this study were 55.6% and 95.5%, respectively, whereas the positive predictive value was 96.2%. Discussion Predictors of response serve as decision-making tools and help treating physicians identify patients who are likely
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