INTERFERON-ALPHA THERAPY IN HCV HEPATITIS - HLA PHENOTYPE AND CIRRHOSIS ARE INDEPENDENT PREDICTORS OF CLINICAL OUTCOME

Interferon-alpha therapy is effective in only similar to 20% of indivi duals with chronic HCV infection. A knowledge of the genetic and/or en vironmental factors that underlie this heterogeneity of response shoul d provide useful predictors of clinical outcome. HCV infected patients and healthy subjects mere selected from the expatriate Egyptian popul ation living in Qatar, where chronic HCV infection poses a serious hea lth problem. HCV infection was confirmed by ELISA and RT-PCR. Fifty fi ve patients received interferon-alpha therapy for 6 months and their r esponse was assessed by liver enzyme activity and histology of liver b iopsies; the patient responses were followed during treatment and for 1 year afterwards. Twenty five patients were characterised as responde rs, and the remaining 30 as non-responders. All individuals in the stu dy were typed for HLA class II alleles. Data were analysed by univaria te and multivarlate statistical methods. Expression of the HLA DR2 Maj or Histocompatibility class II allele is significantly associated with a beneficial response to interferon-alpha therapy in Egyptian patient s (p < 0.005). This association is independent of cirrhosis, the absen ce of which also showed a significant association with response to the rapy (P < 0.005). Our results therefore provide evidence that HLA DR2 is an important additional factor for predicting a long term response to interferon-alpha. therapy in chronic HCV hepatitis. (C) American So ciety for Histocompatibility and Immunogenetics, 1998. Published by El sevier Science Inc.