ANALYSIS OF CLINICAL AND VIROLOGICAL FACTORS ASSOCIATED WITH RESPONSETO ALPHA-INTERFERON THERAPY IN CHRONIC HEPATITIS-C

Interferon alpha (IFN-alpha) therapy is currently the treatment of cho ice for chronic hepatitis C (HCV) infection, but it fails to achieve a sustained response in approximately 75% of those treated. The factors which determine whether or not an individual will respond to IFN-alph a are uncertain, although a number of potentially predictive factors h ave been proposed. In this study a wide range of clinical, demographic , and virological parameters were evaluated in relation to therapeutic outcome in a group of 30 Italian patients with chronic hepatitis C. A ll patients received 3 MU leukocyte-derived IFN-alpha three times a we ek for 6 months and were then followed prospectively for at least 12 m onths. 53% of patients responded initially, but a sustained response w as observed in only 17%. Responders were found to be significantly you nger than nonresponders (45.6 +/- 3.1 vs. 55.4 +/- 2.7), and less freq uently cirrhotic (2/16 vs. 7/14). Sustained responders had a mean pret reatment HCV-RNA titer approximately tenfold lower than that of those who did not have a sustained response, but the difference was not stat istically significant. HCV genotype was found to be significantly asso ciated with both initial and sustained response. Patients infected wit h HCV-2a were more likely to respond (89%) than those who were infecte d with HCV-1b (37%), and they were also more likely to sustain that re sponse (33% vs. 6%). Geometric mean titers did not vary significantly between the different genotypes. (C) 1995 Wiley-Liss, Inc.