Probability of non-response during interferon therapy in patients with chronic hepatitis C

BACKGROUND/AIMS: About 50% of patients with chronic hepatitis C do not resp ond to interferon therapy and this failure is expensive. The aim of this st udy was to identify possible predictive factors of biochemical non-response during interferon therapy among biochemical, virological (HCV genotype), h istological (Knodell's score) and pharmacokinetic (monoethylglycinexylidide formation test) pretreatment parameters. METHODOLOGY: Our study included 60 patients with chronic hepatitis C underg oing a course of Interferon therapy. Patients whose serum ALT levels were n ormal at the 3rd month of therapy and remained so until the end of treatmen t were regarded as responders, RESULTS: In univariate analysis, only the gamma-glutamyltransferase (gamma- GT) and the gamma-GT/alanine aminotranferase ratio were significantly highe r in non-responder patients. Multivariate logistic analysis showed that hig h gamma-GT levels, high histological activity index, low monoethylglycinexy lidide formation rate and viral genotype 1 were the best combination for th e identification of non-responder patients (16.7% error rate). By adding al anine aminotranferase modification at the Ist month of therapy the probabil ity error was reduced to 5%. CONCLUSIONS: These results show that the combination of biochemical, histol ogical, virological and pharmacokinetic pre-treatment variables, associated with alanine aminotranferase modification at the Ist month of therapy, can predict non-response to interferon and allow therapeutic modifications.