Genotype, viral load and age as independent predictors of treatment outcome of interferon- alpha 2a treatment in patients with chronic hepatitis C

• Published in: Scandinavian journal of infectious diseases 1997-01, Vol.29 (1), p.17-22
• Main Authors: Bell, H, Hellum, K, Harthug, S, Maeland, A, Ritland, S, Myrvang, B, Von der Lippe, B, Raknerud, N, Skaug, K, Gutigard, B-G, Skjaerven, R, Prescott, L, Simmonds, P
• Format: Article
• Language: English
• Subjects: hepatitis C virus
• ISSN: 0036-5548
• DOI: 10.3109/00365549709008658

Patients with chronic hepatitis C respond differently when treated with interferon. We randomized 116 patients with chronic hepatitis C in order to compare two dosage regimens of recombinant interferon alpha 2a: 3 MIU x 3 per week for 6 months (arm A) or 6 MIU x 3 per week for 3 months and then 3 MIU x 3 per week for 3 months (arm B). There were no significant differences concerning outcome between the two dose regimens: sustained clearance of HCV viremia 6 months after the end of treatment was obtained in 12/59 (20%) in group A compared with 18/57 (32%) in group B (p = 0.24). In patients with genotype 1a, 4/31 (13%), in genotype 1b, none of 9 (0%), 9/15 (60%) in genotype 2, and 17/58 (29%) in genotype 3, showed sustained clearance of HCV viremia 6 months after the end of treatment (p = 0.002). In a stepwise logistic regression analysis, only pretreatment viral load (p = 0.0001), genotype (p = 0.001) and age (p = 0.04) were identified as independent predictors of sustained clearance of HCV viremia. Liver histology as assessed by Knodell index was significantly improved in patients with sustained HCV RNA response 6 months after the end of treatment (5.2 plus or minus 2.2 vs 2.6 plus or minus 2.2, p < 0.001), but not in responders with relapse or in non-responders. In conclusion, stepwise logistic regression analysis showed that viral load, HCV genotype and age were the only independent predictors for sustained HCV RNA response.