Analysis of clinical and virological factors associated with response to alpha interferon therapy in chronic hepatitis C

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Abstract
Interferon alpha (IFN‐α) therapy is currently the treatment of choice for chronic hepatitis C (HCV) infection, but it fails to achieve a sustained response in approximately 75% of those treated. The factors which determine whether or not an individual will respond to IFN‐α are uncertain, although a number of potentially predictive factors have been proposed. In this study a wide range of clinical, demographic, and virological parameters were evaluated in relation to therapeutic outcome in a group of 30 Italian patients with chronic hepatitis C. All patients received 3 MU leukocyte‐derived IFN‐α three times a week for 6 months and were then followed prospectively for at least 12 months. 53% of patients responded initially, but a sustained response was observed in only 17%. Responders were found to be significantly younger than nonresponders (45.6 ± 3.1 vs. 55.4 ± 2.7), and less frequently cirrhotic (2/16 vs. 7/14). Sustained responders had a mean pretreatment HCV‐RNA titer approximately tenfold lower than that of those who did not have a sustained response, but the difference was not statistically significant. HCV genotype was found to be significantly associated with both initial and sustained response. Patients infected with HCV‐2a were more likely to respond (89%) than those who were infected with HCV‐1 b (37%), and they were also more likely to sustain that response (33% vs. 6%). Geometric mean titers did not vary significantly between the different genotypes.