Treatment of chronic hepatitis C with interferon-alpha. Clinical histological and virological implications.
OBJECTIVE
to identify pretreatment predictive factors of long-term biochemical and virological response to interferon-alpha in chronic hepatitis C and to determine the effects of a second course of interferon-alpha in patients who responded but relapsed after interferon withdrawal.


METHODS
retrospective analysis.


METHODS
outpatient liver clinic of a tertiary hospital in Spain.


METHODS
112 patients with chronic hepatitis C were treated with recombinant interferon-alpha (3 MU three times a week for 6 months). Twenty-four patients who responded but relapsed after interferon withdrawal were treated with a second course of interferon (3 MU three times a week for 12 months).


RESULTS
seventy-two patients were non-responders (64%), 11 patients had a sustained response (10%) and 29 patients responded but relapsed after interferon withdrawal (26%). Five (25%) of the 24 patients who relapsed and were treated with a second course of interferon experienced a sustained response (mean follow-up: 10 months). By multivariate analysis, four pretreatment variables were found to be predictive of a complete response: age < 40 years (p = 0.0004), history of IVDA (p = 0.001), low serum levels (p = 0.013), and genotype 3 (p = 0.01). Two variables were found to be predictive of a sustained response: short duration of HCV infection (p = 0.09) and genotype 3 (p = 0.01). Sustained responders appeared to have lower HCV-RNA levels than those with complete response who relapsed and non-responders. HCV viremia levels were not associated with the severity of liver histology, duration of disease or the source of hepatitis.


CONCLUSIONS
in the present study a low sustained response rate was observed using a standard interferon-alpha regimen (3 MU three times a week for 6 months). The sustained response rate increased slightly with a second course of interferon-alpha (3 MU three times a week for 12 months) in patients with a complete response who relapsed after interferon withdrawal. Sustained response is related to viral genotype and duration of HCV infection.
Olaso
V
V
Servicio de Medicina Digestiva, Hospital Universitario, La Fe. Valencia.
Córdoba
J
J
Berenguer
M
M
Prieto
M
M
Lainez
B
B
Argüello
L
L
Valverde
J
J
Pascual
S
S
Gobernado
M
M
Berenguer
J
J
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D006521:Hepatitis, Chronic / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011379:Prognosis; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D013997:Time Factors; D014158:Transcription, Genetic
D016898:Interferon-alpha; D012367:RNA, Viral