title: Viremia after one month of interferon therapy predicts treatment outcome in patients with chronic hepatitis C.
abstract: OBJECTIVE
  In chronic hepatitis C, interferon alfa induces sustained remission in less than 30% of treated patients. The aim of this study is to analyze viral status early after initiation interferon therapy as a predictor of treatment outcome.
  
  
  METHODS
  One hundred eighty-one patients with chronic hepatitis C who had been treated with interferon alfa for 12 months (median follow-up, 49 months) were studied. Viremia and aminotransferase levels at the first and third months of therapy as well as 10 pretreatment variables were assessed as potential independent predictors of sustained response to treatment.
  
  
  RESULTS
  Sustained response occurred in 51 patients (28%). At month 1 of treatment, viral persistence accurately predicted nonresponse (predictive value, 95.3; 95% confidence interval, 86.0-98.8; P < 0.0001). Independent predictors of sustained response were undetectable viremia at the first month of therapy (P < 0.001), undetectable viremia at the third month (P < 0.001), younger age (P = 0.006), nonsporadic infection (P = 0.012), and higher pretreatment aspartate aminotransferase levels (P = 0.032). In patients who cleared HCV RNA at month 1 of therapy, the predicted probability of sustained response averaged 70% for those younger than 30 years and diminished by 10% for each decade of age.
  
  
  CONCLUSIONS
  Failure to clear HCV RNA at month 1 of treatment is strongly and independently associated with a very low probability of a sustained response to interferon.
authors.affiliation: Department of Internal Medicine, Clinica Universitaria and Medical School, University of Navarra, Pamplona, Spain.
authors.forename: B
authors.initials: B
authors.lastname: Gavier
authors.forename: M A
authors.initials: MA
authors.lastname: Martínez-González
authors.forename: J I
authors.initials: JI
authors.lastname: Riezu-Boj
authors.forename: J J
authors.initials: JJ
authors.lastname: Lasarte
authors.forename: N
authors.initials: N
authors.lastname: Garcia
authors.forename: M P
authors.initials: MP
authors.lastname: Civeira
authors.forename: J
authors.initials: J
authors.lastname: Prieto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D016896:Treatment Outcome; D014766:Viremia / Q000628:therapy*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral; D000410:Alanine Transaminase