LONG-TERM PROGNOSIS OF CHRONIC HEPATITIS-C AFTER TREATMENT WITH INTERFERON-ALPHA-2B AND CHARACTERIZATION OF INCOMPLETE RESPONDERS

Objectives: During the long-term follow-up of chronic hepatitis C pati ents treated with interferon alpha-2b, we have identified some patient s who had continuous normalization, or transient elevation of the seru m alanine aminotransferase levels within the first 6 months of follow- up and subsequent normalization, but HCV RNA was still found to be pos itive during the follow-up period (incomplete responder; ICR). We wish ed to clarify the characteristics of these patients, and to investigat e the factors predictive of the response to interferon. Methods: Seven ty patients were treated with 6 MU of rIFN alpha-2b, three times weekl y for 24 wk. Sixty-six patients (94%) completed the entire therapy and 2-yr follow-up protocol. Results: Twenty-four months after cessation of IFN treatment, 24 patients (36%) were defined as complete responder s (CR; continuously normal alanine aminotransferase levels, and HCV RN A negative). Nine patients (14%) were defined as ICR. Thirty-three pat ients (50%) were defined as nonresponders (NR). Compared with the CR o r NR groups, the patients in the ICR group tended to have the mildest histological severity and lowest histological activity index scores, b ut there were no significant differences in any of the other histologi cal features. The complete response rate was significantly higher in p atients with low concentration of HCV RNA, and genotypes other than ty pe II. Conclusions: After long-term follow-up of the 66 patients, 24 p atients (36%) were CR, nine (14%) were ICR, and 33 (50%) were-NR. The histological stage and indices of chronic hepatitis may help to predic t a patient's response to IFN therapy.