Parameters predicting response to alpha-interferon treatment in chronic hepatitis C.
OBJECTIVE
Sustained response to alpha-interferon treatment for chronic hepatitis C is seen in only 25% of cases. Therefore, it is desirable to define pretreatment factors predicting responders.


METHODS
Forty-nine patients with chronic hepatitis C were treated with a standard alpha-interferon regimen (3 x 3 MU s.c./week). Demographic, biochemical and immunological parameters, and HCV genotypes were obtained prior to initiation of treatment and evaluated for their value in predicting response to alpha-interferon therapy.


RESULTS
Response, as defined by normalization of ALT, was 71% during interferon therapy and sustained response after discontinuation of interferon 24.5%. Patients infected with HCV-genotype 1b had significantly more often "community-acquired" disease. Their outcome was worse with a response rate of 44% during therapy and a sustained response of 12.5%, as compared to 87% and 27% respectively in patients infected with genotypes other than 1b. On multivariate analysis, absence of cirrhosis, HCV-genotype other than 1b, higher ALT levels and higher numbers of CD8 positive liver infiltrates were found to be predictors of response during alpha-interferon therapy.


CONCLUSIONS
Response to alpha-interferon therapy seems to be influenced both by viral virulence factors and by the intensity of the host immune response to HCV.
Glück
T
T
Institut für Immunologie und Molekulare Genetik, Karlsruhe, Germany.
Seelig
R
R
Dette
S
S
Bühring
H J
HJ
Renz
M
M
Kwon
S
S
Wiedmann
K H
KH
Weber
P
P
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D017714:Community-Acquired Infections / Q000628:therapy; D003710:Demography; D004334:Drug Administration Schedule; D005260:Female; D005544:Forecasting; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics / Q000472:pathogenicity; D006526:Hepatitis C / Q000201:enzymology / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000201:enzymology / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D012074:Remission Induction; D016896:Treatment Outcome; D014774:Virulence
D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D000410:Alanine Transaminase