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Retreatment of Chronic Hepatitis C with Interferon Alpha -
Longterm follow-up and prognostic relevance of HCV genotypes
To evaluate the importance of hepatitis C virus (HCV) genotypes
for the long-term response to interferon alpha (IFN alpha) therapy,
we retrospectively investigated 81 patients with chronic hepatitis
C treated within two randomized multicenter studies with comparable
inclusion criteria, Forty patients received recombinant IFN alpha 3
MU three times a week for 12 months and 41 patients lymphoblastoid
IFN alpha 3 or 5 MU three times a week for 6 or 12 months (total
dosage 216-720 MU), The patients were followed up for up to 4 yr
(2- 4 yr, mean 3.2 yr), A sustained remission defined as
normalization of aminotransferases and negative PCR for HCV-RNA was
achieved in 23% of patients treated with recombinant IFN alpha and
in 25% of the group with lymphoblastoid IFN alpha therapy, All
patients with sustained remission showed a normalization of
aminotransferases during the first 3 months of therapy,
Determination of HCV genotypes revealed a major prevalence of type
1 (77%) versus type 2 (5%) and type 3 (18%), The response rate was
significantly higher in patients with type 2 and 3 infections (75
and 73%) than in patients infected with genotype 1 (37%) (p =
0.005). Sustained remission was observed in 13% for genotype 1, in
75% for genotype 2, and in 33% for genotype 3 (differences between
type 2/3 versus type 1, p = 0.03). There were no significant
differences between responders and non- responders concerning age,
level of aminotransferases before therapy or the dosage and type of
IFN alpha administered, The data indicate that the determination of
HCV genotypes may have prognostic relevance in the responsiveness
to IFN alpha therapy. (C) European Association for the Study of the
Liver.
Authors: HOPF U, HUMBOLDT UNIV BERLIN, KLINIKUM RUDOLF
VIRCHOW, MED KLIN & POLIKLIN, DEPT INTERNAL MED D-13353 BERLIN,
GERMANY Publication: JOURNAL OF HEPATOLOGY 1996; 24:67-73
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