IMPORTANCE OF PRETREATMENT VIRAL LOAD AND MONITORING OF SERUM HEPATITIS-C VIRUS-RNA IN PREDICTING RESPONSES TO INTERFERON-ALPHA-2A TREATMENT OF CHRONIC HEPATITIS-C

The aim of this study was to determine what factors correlate with a f avorable response to interferon-alpha 2a (IFN-alpha 2a) treatment in c hronic hepatitis C. Fifty patients with chronic hepatitis C who receiv ed a 26-week treatment with IFN-alpha 2a (474 million units in total) were assessed for pretreatment parameters and biochemical and virologi c events during the treatment. According to biochemical and virologic responses to the treatment, 16 patients (32%) were categorized as sust ained complete responders (SR), 13 (26%) as initial complete responder s (IR), and 21 (42%) as nonresponders (NR). By multivariate analysis, a low viremia level was the only independent predictor of SR among pre treatment parameters (p = 0.0088). The percentage of patients showing hepatitis C virus RNA negativity at 2 and 12 weeks of treatment was si gnificantly higher in SR (94% and 100%, respectively) or IR (69% and 9 2%, respectively) than in NR (14% and 33%, respectively) (p = 0.001). In contrast, the normalization of serum alanine aminotransferase level s at both time points failed to differentiate among SR, IR, and NR. Th ese results indicate that monitoring of serum hepatitis C virus RNA at an appropriate time during treatment in addition to determination of pretreatment viral load is important in predicting responses to IFN-al pha 2a treatment.