Clinical and histologic predictors of response to interferon-α in patients with chronic hepatitis C viral infection

Abstract

To evaluate if any pretreatment characteristics of patients with chronic hepatitis C (HCV) can be used to predict response to the current recommended dose (3 million units three times a week) and higher doses of interferon-alpha (IFN), we retrospectively assessed the response of 37 patients with HCV who were treated with IFN. Sixteen patients (43%) responded to the standard dose of IFN with normalization of ALT. Weight and liver histology were found to be significant factors for response. The responders weighed significantly less than nonresponders (161.8 +/- 35.5 lb versus 200.3 +/- 45.4 lb, P = 0.008). Seventy-five percent of patients with chronic lobular or persistent hepatitis were responders, whereas only 28% of patients with more advanced hepatitis responded (P = 0.01). There was no correlation between the degree of bile duct damage or steatosis and response rate. This study suggests that obesity and severe histologic injury are negative predictive factors of response to the current recommended dose of IFN. The adequacy of the current recommended dose of IFN in overweight patients needs to be investigated.

Combination therapy with thymosin α1 and interferon for the treatment of chronic hepatitis C infection: A randomized, placebo-controlled double-blind trial†

“…In contrast, 19% of patients receiving the 3-MU dose had chronic persistent hepatitis in the multicenter trial of Davis et al 6 However, cirrhosis was seen much more commonly in this trial than in the current IFN/TA1 study. Lam et al 29 reported that IFN induced complete response in 75% of patients with chronic persistent hepatitis but only 28% of patients with more severe lesions. Therefore, our selection criteria for entry may have biased against response in all arms.…”

Impact of obesity, hepatic steatosis, and insulin resistance on hepatitis C treatment outcomes

“…Numerous studies have shown that the presence of obesity negatively infl uences outcomes of both standard and PEG-IFN-based therapy [ 9•• , 11 , [14][15][16][17][18]. In the large multicenter, multinational study of the effi cacy of PEG-IFN-α -2a, 180 μg/wk, plus RBV, 1000 to 1200 mg/d for 48 weeks, body weight of 75 kg or less was a signifi cant independent predictor of increased odds of achieving SVR (OR, 1.91; 95% CI, 1.27-2.89; P = 0.002) [ 2 ].…”

Advances in the Immunogenetics of Coeliac Disease. Clues for Understanding the Pathogenesis and Disease Heterogeneity

“…This scoring system comprises the four original categories of the Knodell scoring system (18), but the first three represent the activity (grading), whereas the fourth category relates to the staging of chronic hepatitis. Grading of chronic hepatitis activity involved four categories: (a) minimal chronic hepatitis (histological activity index HAI: 1-3), (b) mild chronic hepatitis (HAI: 4-8), (c) moderate chronic hepatitis (HAI: 9-12), and (d) severe chronic hepatitis (HAI: [13][14][15][16][17][18]. Histological staging was based on the extent of fibrosis and the development of cirrhosis: fibrosis 0/1 = no or only mild fibrosis; fibrosis 2 = moderate (portal) fibrosis; fibrosis 3 = severe (bridging) fibrosis; and fibrosis 4 = fully established cirrhosis.…”

“…In chronic hepatitis C, it is generally agreed that interferona (IFN-a) therapy can achieve initial (and, less frequently, sustained) clearance of HCV from the serum and can induce biochemical disease remission in about 50-60% of patients (13)(14)(15)(16). However, half of the responding patients relapse within 6 months after the end of therapy, and eradication of HCV seems an uncommon event.…”