FACTORS PREDICTIVE OF RESPONSE TO INTERFERON-ALPHA THERAPY IN HEPATITIS-C VIRUS-INFECTION

To determine the patient-dependent and virus-related factors that may predict sustained response to interferon-alpha therapy, we prospective ly evaluated 60 consecutive patients with chronic hepatitis C who rece ived a standardized treatment schedule of interferon-alpha. Twenty-eig ht patients achieved a long-term sustained remission, 14 patients had temporary responses during treatment but relapsed after completing it and 14 patients did not respond. Four patients dropped out because of severe side effects and were excluded from evaluation of efficacy. Twe nty-one variables were chosen as possible predictors of sustained resp onse and were analyzed by means of multivariate analysis. Variables re lated to the hepatitis C virus included genotype and concentration in serum before treatment. The former was determined by means of the poly merase chain reaction with genotype-specific primers for genotypes PT, K1, K2a and K2b, which were deduced from nonstructural region 5 of th e hepatitis C virus genome. The latter was measured with a competitive polymerase chain reaction technique. Three variables were statistical ly significant (p < 0.05) on univariate analysis: viral genotype, pret reatment level of viremia and Knodell's fibrosis score. In multivariat e analysis viral genotype and Knodell's fibrosis score were correlated independently with a sustained response (p < 0.05 for both). Incidenc e of sustained response was 40% and 91% in patients with genotypes K1 and K2a, respectively. We conclude that with the treatment schedule us ed, viral genotype was the most useful predictor of a sustained respon se to treatment with interferon-alpha.