Percentage of hepatitis C virus-infected hepatocytes is a better predictor of response than serum viremia levels.
Pegylated alpha-interferon plus ribavirin is the current therapy for chronic hepatitis C virus (HCV) infection. Serum HCV-RNA concentration before treatment has been identified as an independent predictive factor of response. We have compared the percentage of HCV-infected hepatocytes with the concentration of serum HCV-RNA in baseline samples as predictors of response. We included 97 patients with chronic HCV infection (genotype 1), treated with pegylated-interferon-alpha2b plus ribavirin. Of these 97, 38 (39%) were sustained responders and 59 (61%) were not. Statistical differences between responders and nonresponders were found regarding the percentage of infected hepatocytes (6.83+/-4.50% versus 13.44+/-10.05%; P=0.00003) but not in serum HCV-RNA concentration [1.71+/-2.70 (x10(6) IU/L) versus 1.32+/-1.86 (x10(6) IU/L); P=0.40694]. Other factors associated with response were age, gamma-glutamyl transpeptidase level, and absence of previous therapy. Logistic regression demonstrated that percentage of infected hepatocytes (odds ratio, 1.160; 95% confidence interval, 1.065-1.264) and previous therapy (odds ratio, 0.294; 95% confidence interval, 0.109-0.795) were significant predictive factors for response. Therefore, the percentage of infected hepatocytes in liver biopsy before treatment is a better predictive factor of sustained response to 48 weeks of therapy with pegylated alpha-interferon plus ribavirin than serum HCV-RNA concentration in baseline serum sample.
Rodríguez-Iñigo
Elena
E
Fundación para el Estudio de las Hepatitis Virales, C/ Guzmán el Bueno 72, 28015 Madrid, Spain.
López-Alcorocho
Juan Manuel
JM
Bartolomé
Javier
J
Ortiz-Movilla
Nuria
N
Pardo
Margarita
M
Carreño
Vicente
V
D000328:Adult; D001706:Biopsy; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000302:isolation & purification* / Q000502:physiology; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D022781:Hepatocytes / Q000821:virology*; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics; D012372:ROC Curve; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014766:Viremia / Q000097:blood / Q000821:virology*
D012367:RNA, Viral