AGE-RELATED RESPONSE TO INTERFERON-ALFA TREATMENT IN WOMEN VS MEN WITH CHRONIC HEPATITIS-C VIRUS-INFECTION

Background: Interferon alfa is used widely for patients with chronic h epatitis C virus (HCV) infection. Little is known, however, of the rel ationship between patients' sex and the effectiveness of interferon al fa treatment in these patients. Methods: We treated 311 patients (199 men and 112 women) with human lymphoblastoid interferon (6 million uni ts subcutaneously every day for 2 weeks and 3 times a week for 22 week s) and observed them for an additional 6 months. Serum HCV RNA levels and genotype were tested by polymerase chain reaction before treatment . A liver biopsy was also done. For the purposes of this study, a comp lete response was defined as the elimination of HCV RNA for at least 6 months after the termination of treatment. Results: The rate of compl ete response was 27.1% for men and 24.1% for women. With multiple logi stic regression analysis, the HCV RNA level (P<.001), genotype (P<.001 ), patients' sex (P<.05), and the interaction between sex and age were associated with a complete response to interferon alfa. The rate of c omplete response was 33.3% in men aged 39 years and younger, 25.0% in men aged 40 years and older, 75.0% in women aged 39 years and younger, and 15.6% in women aged 40 years and older. The odds ratio by group w as 1.00, 0.72, 4.38, and 0.21, respectively. Conclusions: Our finding that women aged 39 years and younger are responsive to interferon alfa treatment suggests that hormonal activity, in particular the level of estrogen, may be associated with the sustained elimination of HCV.