Persistent transaminase elevations in chronic hepatitis C patients with virological response during peginterferon and ribavirin therapy.
OBJECTIVE
The aim of this study was to determine the incidence of persistently abnormal transaminase levels despite clearance of serum hepatitis C virus (HCV) RNA during antiviral therapy for chronic hepatitis C.


METHODS
One hundred and fifty-one patients with chronic hepatitis C undergoing peginterferon alpha and ribavirin therapy and post-treatment follow-up for 24 weeks were included. The blood cell counts, liver biochemistry and serum HCV RNA levels were determined before, during and at 24 weeks after treatment.


RESULTS
Overall, 104 patients (68.9%) achieved sustained virological response. Fifty-four of them (52%) had persistently abnormal transaminase levels during treatment despite clearance of serum HCV RNA. Among them, 27 patients (26%) had persistently abnormal serum AST and ALT levels and another 17 patients (16.3%) displayed isolated elevated AST levels. These 44 patients had normalized transaminase levels by two to three months after the end of treatment. The delayed biochemical response correlated with a higher baseline hepatic fibrosis stage (p=0.017) and liver cirrhosis (p=0.001).


CONCLUSIONS
Approximately 42% of the patients eventually achieving sustained virological response following peginterferon alpha and ribavirin therapy showed delayed biochemical normalization. Delayed biochemical response was associated with the baseline hepatic fibrosis stage and liver cirrhosis.
Su
Wen-Pang
WP
Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Peng
Cheng-Yuan
CY
Lai
Hsueh-Chou
HC
Liao
Kuan-Fu
KF
Huang
Wen-Hsin
WH
Chuang
Po-Heng
PH
Chen
Chih-Bin
CB
Jeng
Long-Bin
LB
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D012307:Risk Factors; D000637:Transaminases / Q000097:blood*; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000637:Transaminases; C100416:peginterferon alfa-2a