Chronic hepatitis C and interferon alfa therapy: predictors of long term response
| Autor: | Bowden Ds, Cromie Sl, Jenkins Pj, Francis J. Dudley, Caroline F. Finch |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Hepatitis C virus Alpha interferon medicine.disease_cause Gastroenterology Predictive Value of Tests Internal medicine medicine Humans Interferon alfa Hepatitis biology business.industry Interferon-alpha Alanine Transaminase General Medicine Hepatitis C gamma-Glutamyltransferase medicine.disease Treatment Outcome Alanine transaminase Immunology Chronic Disease Multivariate Analysis biology.protein Female Viral disease business Viral load Biomarkers medicine.drug |
| Zdroj: | The Medical journal of Australia. 164(3) |
| ISSN: | 0025-729X |
| Popis: | OBJECTIVE: To identify independent patient, disease and viral characteristics that predict a sustained biochemical or viral response to interferon alfa therapy in patients with chronic hepatitis C. DESIGN: Comparison of interferon responders and non-responders by univariate and multivariate analysis. SETTING: The hepatitis clinic of the Alfred Hospital, Melbourne (a tertiary referral hospital), between July 1989 and June 1994. SUBJECTS: All patients with chronic hepatitis C who were treated with interferon alfa (IFN-alpha; 3 million IU, three times a week or more) for at least 12 weeks. OUTCOME MEASURES: Patient demographic and epidemiologic characteristics, pretreatment serum alanine aminotransferase (ALT) and 2-gamma-glutamyl transpeptidase (GGT) levels, histological grading of hepatic steatosis, necroinflammatory activity and fibrosis, serum hepatitis C virus (HCV) RNA titres and genotype and post-treatment serum ALT levels and presence of HCV RNA. RESULTS: Of 58 patients, 13 (22%) had a sustained (six months or longer) biochemical response to IFN-alpha therapy, including 12 (21%) with a sustained viral response. Univariate analysis showed that young patients with a normal serum GGT level, grade 0-1 steatosis and fibrosis, low viral titre and infection with genotypes 3a and 2a were more likely to have a sustained response. Infection with genotypes other than 1a and 1b was the only independent variable associated with both a sustained biochemical and viral response. After adjusting for genotype, a hepatic fibrosis grade of 0-1 was also independently associated with viral response. This logistic regression model accurately predicted the virological response in 80% of cases. CONCLUSION: In Australian patients with chronic hepatitis C, a sustained viral response to IFN-alpha therapy is most likely in those infected with a genotype other than 1a or 1b and with minimal hepatic fibrosis. |
| Databáze: | OpenAIRE |
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