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BACKGROUND. The long term efficacy of combination therapy with transcatheterKatsuaki Tanaka, M.D.arterial embolization (TAE) followed by percutaneous ethanol injection (PEI) was Saburo Nakamura, M.D. stage of cirrhosis (Child's Class A vs. Class B or C), and the size of the largest lesion (3-5 cm in largest dimension compared with ú 5 cm) significantly affected the Third Department of Internal Medicine, Yokosurvival rate (P õ 0.05 to P õ 0.01, log rank test). The 3-, 5-, and 7-year survival hama City University School of Medicine, Yokorates of the Child's Class A patients who had a 3-5 cm solitary lesion (n Å 22) were hama, Japan.100%, 75%, and 27%, respectively. The Cox proportional hazards model showed the stage of cirrhosis and size of the largest lesion to be independently associated with survival. No serious complications occurred during or after treatment. PEI has been reported to be high compared with that of small lesions. CONCLUSIONS. Combination therapy with15

Hepatitis C virus (HCV) genotype 2a or 2b is associated with a favorable outcome after interferon therapy. However, 19% to 33% of patients do not respond to therapy. We investigated whether interferon receptor gene (IFNAR1 and IFNAR2 mRNA) expression in the liver before interferon therapy predicts long-term response to therapy in patients with genotype 2a or 2b HCV infection. Twenty-seven patients who subsequently received interferon-alpha therapy underwent liver biopsies before interferon therapy. Hepatic IFNAR1 and IFNAR2 mRNA were determined using a reverse transcription-polymerase chain reaction assay. Twenty (74%) patients responded to interferon therapy, while the remaining seven (26%) patients were nonresponders. The expression rates of IFNAR1 and IFNAR2 mRNA in the liver were significantly higher in responders than nonresponders (p < 0.01, by chi-square test). The presence of either IFNAR1 or IFNAR2 mRNA predicted complete response to interferon treatment, with a positive predictive value of 100%. Multiple logistic regression analysis showed that IFNAR1 and/or IFNAR2 mRNA expression was the only significant predictor of the effectiveness of IFN therapy (p = 0.0002). We conclude that expression of interferon receptor genes in the liver is a useful index for predicting the long-term efficacy of interferon therapy in patients with chronic genotype 2a or 2b HCV infection.