TREATMENT OF CHRONIC HEPATITIS-C WITH INTERFERON-ALPHA - LONG-TERM FOLLOW-UP AND PROGNOSTIC RELEVANCE OF HCV GENOTYPES

To evaluate the importance of hepatitis C virus (HCV) genotypes for th e long-term response to interferon alpha (IFN alpha) therapy, we retro spectively investigated 81 patients with chronic hepatitis C treated w ithin two randomized multicenter studies with comparable inclusion cri teria, Forty patients received recombinant IFN alpha 3 MU three times a week for 12 months and 41 patients lymphoblastoid IFN alpha 3 or 5 M U three times a week for 6 or 12 months (total dosage 216-720 MU), The patients were followed up for up to 4 yr (2-4 yr, mean 3.2 yr), A sus tained remission defined as normalization of aminotransferases and neg ative PCR for HCV-RNA was achieved in 23% of patients treated with rec ombinant IFN alpha and in 25% of the group with lymphoblastoid IFN alp ha therapy, All patients with sustained remission showed a normalizati on of aminotransferases during the first 3 months of therapy, Determin ation of HCV genotypes revealed a major prevalence of type 1 (77%) ver sus type 2 (5%) and type 3 (18%), The response rate was significantly higher in patients with type 2 and 3 infections (75 and 73%) than in p atients infected with genotype 1 (37%) (p = 0.005). Sustained remissio n was observed in 13% for genotype 1, in 75% for genotype 2, and in 33 % for genotype 3 (differences between type 2/3 versus type 1, p = 0.03 ). There were no significant differences between responders and non-re sponders concerning age, level of aminotransferases before therapy or the dosage and type of IFN alpha administered, The data indicate that the determination of HCV genotypes may have prognostic relevance in th e responsiveness to IFN alpha therapy. (C) European Association for th e Study of the Liver.