PERMANENT RESPONSE TO ALPHA-INTERFERON THERAPY IN CHRONIC HEPATITIS-CIS PRECEDED BY RAPID CLEARANCE OF HCV-RNA FROM SERUM

Background/Aims: Prediction of response to interferon therapy is impor tant in the management of chronic hepatitis C. Pre-therapy data are va luable but they may be inaccurate in some cases, Our aim was to invest igate whether the biochemical and virological events that occur early during interferon therapy in chronic hepatitis C may predict the final result of the treatment, Methods: ALT and serum HCV-RNA were serially measured in 53 HCV-RNA-positive patients who received a standard 6-mo nth course of interferon therapy, Eleven patients with a sustained res ponse, 23 who responded but subsequently relapsed and 19 who did not r espond were studied, HCV-RNA was measured with a commercial kit (Ampli cor HCV), Results: After 4 weeks of treatment, HCV-RNA became negative in 73% of sustained responders, in 26% of transient responders (p=0.0 2) and in none of the non-responders, Corresponding figures after 8 we eks of therapy were 82% in sustained responders, 61% in transient resp onders and 9% in non-responders, The difference between sustained and transient responders at this time was not significant, After 4 weeks o f therapy, 82% of sustained responders, 52% of transient responders an d none of the non-responders presented normalization of alanine transf erase, The difference between sustained and transient responders was n ot significant, Corresponding figures for normalization of alanine tra nsferase at 8 weeks were 82%, 96% and 0% respectively, At the end of t reatment, all sustained responders, 70% of transient responders and no ne of the non-responders had cleared HCV-RNA from serum, Conclusions: A rapid normalization of alanine transferase induced by interferon the rapy is associated with response, but does not differentiate between t ransient and permanent response, In contrast, clearance of HCV-RNA aft er 4 weeks of treatment, but not after 8 weeks, is significatively ass ociated With sustained response, Testing for HCV-RNA early during inte rferon administration may be valuable for further decisions concerning therapy in patients with chronic hepatitis C.