Evaluation of long-term biochemical responses to combination therapy of interferon plus ribavirin in those infected with hepatitis C virus genotype 1b and high baseline viral load.
OBJECTIVE
The aim of this study was to determine the long-term effects in non-responders (NRs) to 48-week interferon (IFN) and ribavirin combination treatment in patients infected with hepatitis C virus (HCV) genotype 1b and high baseline viral loads.


METHODS
We measured serum alanine aminotransferase (ALT) and HCV-RNA levels in 52 consecutive patients infected with HCV genotype 1b and high viral loads who received combination therapy for 48 weeks.


RESULTS
Sustained virologic response (SVR) was noted in 30 patients (57.7%). Virologic response (VR), that is serum HCV-RNA negativity by the end of treatment and positivity during follow-up, was noted in nine patients (17.3%). Thirteen (25.0%) patients were NRs. Significantly lower serum albumin (P = 0.007) and ribavirin doses according to body weight (P = 0.021) and higher gamma glutamyl transpeptidase (GGT,P = 0.038) were noted at baseline in the NR group than in the SVR and VR groups. ALT normalization rates at six months after the completion of treatment were 55.6% (5/9) in VR and 61.5% (8/13) in NRs. Sustained ALT normalization at two years after the completion of treatment was noted in 55.6% (5/9) and 58.3% (7/12), respectively.


CONCLUSIONS
Our study indicates a high rate of ALT normalization in patients infected with HCV genotype 1b and high baseline viral loads who received combination therapy and that such a rate could be maintained after the completion of therapy, even in NRs. Our results suggest that combination therapy should be continued in NRs who show ALT normalization in order to prevent potential hepatocarcinogenesis.
Sezaki
Hitomi
H
Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
Suzuki
Fumitaka
F
Kawamura
Yusuke
Y
Yatsuji
Hiromi
H
Hosaka
Tetsuya
T
Akuta
Norio
N
Kobayashi
Masahiro
M
Suzuki
Yoshiyuki
Y
Arase
Yasuji
Y
Ikeda
Kenji
K
Kumada
Hiromitsu
H