Parameters predicting response to alpha-interferon treatment in chronic hepatitis C.

Background/Aims: Sustained response to a-interferon treatment for chronic hepatitis C is seen in only 25% of cases. Therefore, it is desirable to define pretreatment factors predicting responders. Materials and methods: Forty-nine patients with chronic hepatitis C were treated with a standard a-interferon regimen (3 x 3 MU s.c./week). Demographic, biochemical and immunological parameters, and HCV genotypes were obtained prior to initiation of treatment and evaluated for their value in predicting response to a-interferon therapy. Results: Response, as defined by normalization of ALT, was 71% during interferon therapy and sustained response after discontinuation of interferon 24.5%. Patients infected with HCV-genotype 1b had significantly more often community-acquired disease. Their outcome was worse with a response rate of 44% during therapy and a sustained response of 12.5%, as compared to 87% and 27% respectively in patients infected with genotypes other than 1b. On multivariate analysis, absence of cirrhosis, HCV-genotype other than 1b, higher ALT levels and higher numbers of CD8 positive liver infiltrates were found to be predictors of response during a-interferon therapy. Conclusion: Response to a-interferon therapy seems to be influenced both by viral virulence factors and by the intensity of the host immune response to HCV.