title: The determination of GGT is the most reliable predictor of nonresponsiveness to interferon-alpha based therapy in HCV type-1 infection.
abstract: BACKGROUND
  The critical analysis of baseline factors has been found to be useful to predict virologic nonresponse (NR), relapse, or sustained virologic response (SVR) in patients infected with hepatitis C virus (HCV) who receive antiviral therapy. In the present retrospective study we tried to find out whether gamma-glutamyltranspeptidase (GGT) may be one of the baseline factors which are of special predictive power. We analyzed, in patients with different treatment outcomes, the predictive power of established baseline factors either in combination with GGT or by evaluating the predictive value of GGT independently.
  
  
  METHODS
  Individual data from 632 patients chronically infected with HCV type 1 (n = 561) or type 2/3 (n = 71) were analyzed. All patients had received their first course of antiviral therapy and were treated with pegylated interferon α-2a or -2b plus ribavirin.
  
  
  RESULTS
  In patients with HCV type 1, a multivariate multinomial logistic regression analysis identified low GGT (p < 0.0001), high cholesterol (p < 0.0001), age ≤ 40 years (p < 0.0001), high alanine aminotransferase (p = 0.0006), low viremia (p = 0.0014), and absence of cirrhosis (p = 0.0164) as independent predictors. While these baseline factors heralded improved virologic response, high GGT, in contrast, was significantly associated with NR (p < 0.0001). A strong correlation was found between log(10) GGT and a scoring variable S (r = -0.26 for prediction of SVR, p < 0.001; r = 0.11 for prediction of NR, p = 0.016) summarizing predictive information from other baseline factors.
  
  
  CONCLUSIONS
  These findings prove the predictive sensitivity of GGT as an independent indicator of nonresponsiveness even at levels that are slightly above the normal range. This new predictive parameter may help to improve individualized therapy in HCV type-1 infection.
authors.affiliation: Universitätsklinikum Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Viola
authors.initials: V
authors.lastname: Weich
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.forename: Tje Lin
authors.initials: TL
authors.lastname: Chung
authors.forename: Christoph
authors.initials: C
authors.lastname: Sarrazin
authors.forename: Holger
authors.initials: H
authors.lastname: Hinrichsen
authors.forename: Peter
authors.initials: P
authors.lastname: Buggisch
authors.forename: Tilman
authors.initials: T
authors.lastname: Gerlach
authors.forename: Hartwig
authors.initials: H
authors.lastname: Klinker
authors.forename: Ulrich
authors.initials: U
authors.lastname: Spengler
authors.forename: Alexandra
authors.initials: A
authors.lastname: Bergk
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.forename: Thomas
authors.initials: T
authors.lastname: Berg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D005723:gamma-Glutamyltransferase; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a