PREDICTION OF THE RESPONSE OF CHRONIC HEPATITIS-C TO INTERFERON-ALFA - A STATISTICAL-ANALYSIS OF PRETREATMENT VARIABLES

Pretreatment variables that could predict the response of chronic hepa titis C to interferon alfa treatment have not been fully assessed. Eig hteen baseline variables were evaluated in a series of 100 consecutive patients treated with a 12 month course of interferon alfa. For the p urposes of this study, response was defined as the return to normal of aminotransferase activities before the third month of treatment. Seve nty per cent of the patients responded to treatment. Six variables wer e associated with an increased likelihood of response assessed by univ ariate analysis. With stepwise multiple regression analysis assessment , however, only three variables remained independently predictive of r esponse: low gamma glutamyltransferase (gammaGT) activities (p<0.001), absence of obesity (p=0.005), and absence of cirrhosis (p=0.01). The response rate in patients with gammaGT activities < 0.66 mukat/l (n=55 ) was 78% and 60% in patients with values >0.66 mukat/l (n=45) (p=0.04 8). Response was attained in 75% of non-obese patients (n=80), compare d with only 50% of obese patients (n=20) (p=0.03). Finally, 80% of pat ients without cirrhosis (n=76) responded, while among those with cirrh osis (n=24) the response rate was only 37% (p<0.001). All 23 patients without cirrhosis, < 40 years old, and with gammaGT activities <0.66 m ukat/l responded to treatment, while only 28.5% of 14 patients with ci rrhosis, >40 years old, and with gammaGT activities >0.66 mukat/l resp onded to interferon alfa (p<0.001). Those findings may be useful when evaluating interferon alfa trials and it is suggested that this treatm ent should be applied early in the course of chronic hepatitis C.