Pretreatment hepatitis C virus dynamics for predicting virological response to interferon-alpha2b monotherapy in patients with chronic hepatitis C virus infection.
One hundred and forty-one patients with chronic hepatitis C virus (HCV) infection treated with 6 MIU of interferon (IFN)-alpha2b for 24 weeks were studied to compare pretreatment viral dynamics during 1 month before the initiation of treatment (DeltaHCV) with other predictive factors. The patients were classified into three groups according to DeltaHCV: the Increase group (DeltaHCV >0.20log copies/ml/month), the Stable group (-0.20</=DeltaHCV</=0.20log copies/ml/month) and the Decrease group (DeltaHCV<-0.20log copies/ml/month). The sustained response (SR) rates were 0/40 (0%) in the Increase group, 6/54 (11.1%) in the Stable group and 25/47 (53.2%) in the Decrease group (P<0.0001). Based on the HCV RNA level at baseline, the SR rates were lower in the Increase group than that in the Decrease group in less than 5.0log copies/ml (0% vs. 100.0%, P=0.0132) and at 5.00-5.49log copies/ml (0% vs. 81.8%, P=0.0270), respectively. The pretreatment HCV RNA decrease was determined as independent predictors of SR by multivariable logistic regression analysis (P<0.0001). For serial assays of HCV RNA during treatment, there was not significant difference in mean HCV RNA level at baseline but was significantly different on day 14 between the Decrease and the Nondecrease groups (1.15 vs. 2.21log copies/ml, P=0.0417). These results suggest that DeltaHCV is independently associated with the IFN response and is useful for determining the indication of IFN treatment.
The First Department of Internal Medicine, Iwate Medical University, 19-1 Uchimaru, Iwate 020-8505, Morioka, Japan
Shigehiko
S
Sainokami
Kouichi
K
Abe
Kazuyuki
K
Suzuki
Kazuyoshi
K
Ishikawa