title: Factors predicting interferon treatment response in patients with chronic hepatitis c: late viral clearance does not preclude a sustained response.
abstract: OBJECTIVE
  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.
authors.affiliation: Finnish Red Cross Blood Transfusion Service, Helsinki.
authors.forename: F
authors.initials: F
authors.lastname: Ebeling
authors.forename: M
authors.initials: M
authors.lastname: Lappalainen
authors.forename: M
authors.initials: M
authors.lastname: Vuoristo
authors.forename: H
authors.initials: H
authors.lastname: Nuutinen
authors.forename: R
authors.initials: R
authors.lastname: Leino
authors.forename: A L
authors.initials: AL
authors.lastname: Karvonen
authors.forename: J
authors.initials: J
authors.lastname: Lehtola
authors.forename: R
authors.initials: R
authors.lastname: Julkunen
authors.forename: P
authors.initials: P
authors.lastname: Pohjanpelto
authors.forename: M
authors.initials: M
authors.lastname: Färkkilä
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012367:RNA, Viral