Assessment of selected clinical factors as predictors of response to combined interferon-alpha plus ribavirin therapy among patients with chronic hepatitis C
Wiesław Kryczka, Dorota Zarębska-Michaluk, Magdalena Chrapek
Med Sci Monit 2003; 9(3): 32-35
Background: Combined interferon-alpha (IFN) plus ribavirin therapy is recommended as first-line regimen treatment of chronic hepatitis C (CHC) patients. The aim of the study was to evaluate the selected clinical factors in the prediction of response to IFN with ribavirin for initial therapy and retreatment of CHC. Material/Methods:Ninety eight consecutive CHC patients who completed the combined IFN with ribavirin therapy (24 or 48 weeks), including 79 naive patients (age: 41.0+/-10.9 yrs; 51M; NAIVE group) and 19 nonsustained responders to prior IFN monotherapy (age: 40.8+/-10.2 yrs; 10M; RETHERAPY group). Sustained Response (SR) was defined as persistent normalization of ALT and loss of serum HCV-RNA 6 months after the end of treatment; all other patients were defined as nonresponders (NR). Age, gender, pretreatment histology (assessed according to Ishak`s scoring system) and baseline ALT, g-GTP and iron serum levels were compared in SR and NR patients, separately in NAIVE and RETHERAPY groups. Results: The baseline clinical characteristics of NAIVE and RETHERAPY group did not differ significantly. 28 of 79 (35.4%) NAIVE patients and 9 of 19 (47.4%) RETHERAPY patients achieved SR to the therapy. NAIVE sustained responders presented significantly lower staging scores and g-GTP levels in comparison with nonresponders. Multivariate logistic regression analysis showed that only fibrotic score lower than 3 was independently (p=0.04) associated with SR. In RETHERAPY group, only female gender was positively correlated with SR. The other analyzed parameters did not significantly differ between responders and nonresponders.Conclusions: The results of the present study suggest that sustained response to combined therapy in naive CHC patients is associated with absence or minimal hepatic fibrosis prior to the therapy. Among retherapy patients, females are more likely to achieve sustained response, irrespective of fibrosis stage.
Keywords: chronic hepatitis C, treatment, interferon, ribavirin, retherapy