PREDICTIVE VALUE OF AMINOTRANSFERASE AND HEPATITIS-B VIRUS-DNA LEVELSON RESPONSE TO INTERFERON THERAPY FOR CHRONIC HEPATITIS-B

In a previously reported randomized controlled trial of interferon-alp ha (IFN-alpha) for chronic hepatitis B, we found a significant differe nce in response between Chinese adults with elevated vs normal pretrea tment aminotransferase (ALT) levels. The aim of this study was to dete rmine the correlation between serum hepatitis B virus (HBV) DNA levels and response to IFN therapy. HBV DNA levels in residual stored sera f rom patients who participated in the above trial were quantified by a branched DNA (bDNA) assay. Nominal logistic regression was used to est imate the probability of response to IFN treatment as a function of pr etreatment ALT and/or HBV DNA levels. We found a significant (P<0.01) correlation between the HBV DNA levels at midtreatment and response to IFN therapy. Response was achieved in 53% of patients who had undetec table HBV DNA levels at midtreatment but in only 17% of those who rema ined HBV DNA positive (P < 0.01). In contrast, the probabilities of re sponse for patients with baseline HBV DNA levels over the range 10 to 10 000 million equivalents (MEq) ml(-1) were almost identical. We also found a significant correlation between the pretreatment ALT levels a nd response to IFN therapy. The probabilities of response for patients with pretreatment ALT levels of 500 and 100 IU l(-1) were higher than for patients with normal ALT levels by two and onefold, respectively. Our findings may help to improve the cost-effectiveness of IFN therap y for chronic hepatitis B by guiding the selection of patients for the rapy and in optimizing the duration of treatment for the individual pa tient.