GENOTYPE, VIRAL LOAD AND AGE AS INDEPENDENT PREDICTORS OF TREATMENT OUTCOME OF INTERFERON-ALPHA-2A TREATMENT IN PATIENTS WITH CHRONIC HEPATITIS-C

Patients with chronic hepatitis C respond differently when treated wit h interferon. We randomized 116 patients with chronic hepatitis C in o rder to compare two dosage regimens of recombinant interferon alpha 2a : 3 MIU x 3 per week for 6 months (arm A) or 6 MIU x 3 per week for 3 months and then 3 MIU x 3 per meek for 3 months (arm B). There were no significant differences concerning outcome bet between the two dose r egimens: sustained clearance of HCV viremia 6 months after the end of treatment was obtained in 12/59 (20%) in group A compared with 18/57 ( 32%) in group B (p=0.24). In patients with genotype 1a, 4/31 (13%), in genotype 1b, none of 9 (0%), 9/15 (60%) in genotype 2, and 17/58 (29% ) in genotype 3, showed sustained clearance of HCV viremia 6 months af ter the end of treatment (p = 0.002). In a stepwise logistic regressio n analysis, only pretreatment viral load (p = 0.0001), genotype (p = 0 .001) and age (p = 0.04) were identified as independent predictors of sustained clearance of HCV viremia. Liver histology as assessed by Kno dell index was significantly improved in patients with sustained HCV R NA response 6 months after the end of treatment (5.2 +/- 2.2 vs 2.6 +/ - 2.2, p < 0.001), but not in responders with relapse or in non-respon ders. In conclusion, stepwise logistic regression analysis showed that viral load, HCV genotype and age were the only independent predictors for sustained HCV RNA response.