Factors predicting interferon treatment response in patients with chronic hepatitis c: late viral clearance does not preclude a sustained response
- PMID: 11316176
- DOI: 10.1111/j.1572-0241.2001.03631.x
Factors predicting interferon treatment response in patients with chronic hepatitis c: late viral clearance does not preclude a sustained response
Abstract
Objectives: Because of the suboptimal efficacy, cost, and adverse effects of interferon in chronic hepatitis C (HCV), predictors have been sought to detect patients with a good treatment response. Also, markers for determining a poor response early in the course of therapy, such as the lack of early viral clearance, have been proposed.
Methods: Ninety-seven patients with chronic hepatitis C were enrolled to receive leukocyte alpha-interferon according to a stepped-care management protocol. The final virological treatment response was evaluated in 74 patients after a 6-month post-treatment follow-up. The relationship between pretreatment and during-treatment variables and the long-term response was assessed.
Results: Non-1 viral genotype, higher pretreatment ALT levels, and lower gamma-glutamyl transferase (GGT)/ALT ratios and GGT as well as younger age were significantly associated with a sustained response; a trend was also detected for lower serum ferritin levels. Normalization of ALT by 3 months was also a significant predictor of a long-term response. Of the 27 patients carrying the HCV genotype 3a, seven (26%) were still HCV RNA positive at 6 months. Of these patients, however, five (19%) still achieved a sustained virological response after treatment for up to 12 months.
Conclusions: In contrast to some previous reports, our results suggest that a late viral clearance after 6 months of interferon monotherapy may not preclude a favorable long-term response after a 12-month treatment, especially in patients carrying a non-1 HCV genotype. A low pretreatment GGT/ALT ratio is a predictor of a good treatment response.
Comment in
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24 weeks of interferon-ribavirin therapy should not routinely be given to all hepatitis C patients.Am J Gastroenterol. 2002 Feb;97(2):497-8. doi: 10.1111/j.1572-0241.2002.05512.x. Am J Gastroenterol. 2002. PMID: 11866304 No abstract available.