N. Yuki et al., PRETREATMENT VIRAL LOAD AND RESPONSE TO PROLONGED INTERFERON-ALPHA COURSE FOR CHRONIC HEPATITIS-C, Journal of hepatology, 22(4), 1995, pp. 457-463
Background/Aims: We investigated the clinical benefit of long-term int
erferon therapy in chronic hepatitis C in relation to the pretreatment
viral load and genotypes. Methods: Chronic hepatitis C patients were
randomly assigned to receive 28-week (n=45) or 52-week (n=43) courses
of interferon-alpha. The responses were correlated with pretreatment v
iremic levels assessed by a branched DNA assay and genotypes. Results:
After the 28-week interferon-alpha course, sustained aminotransferase
normalization showed correlation with a lower initial viral load. The
normalization was achieved by 78% (7/9) of the low viremic (branched
DNA-negative) patients, but only 22% (8/36) of the highly viremic (bra
nched DNA-positive) patients (p<0.01), Treatment with the 52-week inte
rferon-alpha course increased the incidence of a sustained response in
highly viremic patients and led to a decrease in relapse after therap
y withdrawal (p<0.05). Thus, 75% (6/8) of the low viremic patients and
49% (17/35) of the highly viremic patients showed a sustained respons
e. The data further showed that frequent sustained responses in patien
ts with genotypes III and IV were associated with a low initial viral
load. Conclusions: These findings suggest that although the pretreatme
nt viral load is an important virological factor for predicting respon
ses to interferon in chronic hepatitis C, relapse in highly viremic pa
tients may be prevented by long-term therapy.