Permanent response to ALPHA-INTERFERON therapy in Chronice
Hepatitis C is preceded by rapid clearance of HCV-RNA from
serum
Background/Aims:
Prediction of response to interferon therapy is important in the
management of chronic hepatitis C. Pre-therapy data are valuable
but they may be inaccurate in some cases, Our aim was to
investigate whether the biochemical and virological events that
occur early during interferon therapy in chronic hepatitis C may
predict the final result of the treatment, Methods: ALT and serum
HCV-RNA were serially measured in 53 HCV-RNA-positive patients who
received a standard 6-month course of interferon therapy, Eleven
patients with a sustained response, 23 who responded but
subsequently relapsed and 19 who did not respond were studied, HCV-
RNA was measured with a commercial kit (Amplicor HCV)
Results:
After 4 weeks of treatment, HCV-RNA became negative in 73% of
sustained responders, in 26% of transient responders (p=0.02) and
in none of the non-responders, Corresponding figures after 8 weeks
of therapy were 82% in sustained responders, 61% in transient
responders and 9% in non-responders, The difference between
sustained and transient responders at this time was not
significant, After 4 weeks of therapy, 82% of sustained responders,
52% of transient responders and none of the non-responders
presented normalization of alanine transferase, The difference
between sustained and transient responders was not significant,
Corresponding figures for normalization of alanine transferase at 8
weeks were 82%, 96% and 0% respectively, At the end of treatment,
all sustained responders, 70% of transient responders and none of
the non-responders had cleared HCV-RNA from serum,
Conclusions:
A rapid normalization of alanine transferase induced by interferon
therapy is associated with response, but does not differentiate
between transient and permanent response, In contrast, clearance of
HCV-RNA after 4 weeks of treatment, but not after 8 weeks, is
significatively associated With sustained response, Testing for
HCV-RNA early during interferon administration may be valuable for
further decisions concerning therapy in patients with chronic
hepatitis C.
Author: JM SANCHEZTAPIAS, UNIV BARCELONA, LIVER UNIT, HOSP
CLIN, FAC MED, DEPT MED, VILLARROEL 170 E-08036 BARCELONA,
SPAIN
Source: JOURNAL OF HEPATOLOGY 1996 DEC;25(6):827-832
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