Prediction of the response of chronic hepatitis C to interferon alfa: a statistical analysis of pretreatment variables.

Abstract

Pretreatment variables that could predict the response of chronic hepatitis C to interferon alfa treatment have not been fully assessed. Eighteen baseline variables were evaluated in a series of 100 consecutive patients treated with a 12 month course of interferon alfa. For the purposes of this study, response was defined as the return to normal of aminotransferase activities before the third month of treatment.Seventy per cent of the patients responded to treatment. Six variables were associated with an increased likelihood of response assessed by univariate analysis. With stepwise multiple regression analysis assessment, however, only three variables remained independently predictive of response: low y glutamyltransferase (yGT) activities (p<0.001), absence of obesity (p=0.005), and absence of cirrhosis (p=0-01). The response rate in patients with yGT activities <066 iikat/l (n=55) was 78% and 60% in patients with values >066 ikat/l (n=45) (p=.0048). Response was attained in 75% of non-obese patients (n=80), compared with only 50% of obese patients (n=20) (p=003). Finally, 80% of patients without cirrhosis (n=76) responded, while among those with cirrhosis (n=24) the response rate was only 37% (p<0001). All 23 patients without cirrhosis, <40 years old, and with yGT activities <0-66 tkat/l responded to treatment, while only 28-5% of 14 patients with cirrhosis, >40 years old, and with yGT activities >0 66 pkat/l responded to interferon affa (p<0-001).Those findings may be useful when evaluating interferon alfa trials and it is suggested that this treatment should be applied early in the course of chronic hepatitis C.

Obesity and Its Nurturing Effect on Hepatitis C

“…The first is that obesity is an independent factor that diminishes the eradication rate of IFN-based treatment. This confirms previous studies [7][8][9] that suggested obesity to be an independent negative predictor of HCV response to treatment. Although the mechanism by which obesity diminishes the efficacy of antiviral treatment in the HCV patients remains to be elucidated, there are at least 3 likely possibilities.…”

Prediction of successful outcome in a randomised controlled trial of the long-term efficacy of interferon alpha treatment for chronic hepatitis C

“…Many retrospective analyses have identified several host and viral factors associated with an increased probability of sustained long-term response to therapy with IFN-␣ [Camps et al, 1993;Tsubota et al, 1994;Conjeevaram et al, 1995;Yamada et al, 1995]. Early age, recent occurrence of the disease, low HCV-RNA levels, absence of cirrhosis, low hepatic iron, and low genetic complexity of infecting HCV quasi-species [Kanazawa et al, 1994;Enomoto et al, 1995] prior to treatment are dominant factors.…”

Steatosis: Co-factor in Other Liver Diseases *

“…8 The development of cirrhosis in patients with HCV may be associated with regression of steatosis, 21 as has previously been documented in non-alcoholic steatohepatitis (NASH). 22,23 The mechanisms leading to a reduction in steatosis in the liver with cirrhosis remain Mihm et al 99 Yes Ratziu et al 18 Yes Fartoux et al 19 Yes Czaja et al 9 Yes Yes Yes Hourigan et al 10,11 Yes Yes Yes Adinolfi et al 12 Yes Yes Yes Yes Westin et al 13 Yes Weak Yes Yes Castera et al 14 Yes Yes Monto et al 15 Yes Yes Yes Kumar et al 100 Yes Camps et al 101 Yes (BMI) Kaserer et al 102 Yes Bressler et al 60 Yes (BMI) Rubbia-Brandt et al 28 Yes Yes Poynard et al 16 Yes Yes Yes Yes Yes Patton et al 17 Yes Yes Yes Yes Yes Nair et al 70 No* Marrero et al 103 Yes Ohata et al 74 Yes *Steatosis was a risk for HCC in alcoholic and cryptogenic cirrhosis only. Abbreviation: BMI, body mass index.…”