title: 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.
abstract: 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.
authors.affiliation: Department of Hepatology, Toranomon Hospital, Tokyo, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sezaki
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Suzuki
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Hiromi
authors.initials: H
authors.lastname: Yatsuji
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Hosaka
authors.forename: Norio
authors.initials: N
authors.lastname: Akuta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yasuji
authors.initials: Y
authors.lastname: Arase
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada