Viremia after one month of interferon therapy predicts treatment outcome in patients with chronic hepatitis C.
Background & Aims
In chronic hepatitis C, interferon alfa induces sustained remission in less than 30% of treated patients.
The aim of this study is to analyze viral status early after initiation interferon therapy as a predictor of treatment outcome.
One hundred eighty-one patients with chronic hepatitis C who had been treated with interferon alfa for 12 months (median follow-up, 49 months) were studied.
Viremia and aminotransferase levels at the first and third months of therapy as well as 10 pretreatment variables were assessed as potential independent predictors of sustained response to treatment.
Sustained response occurred in 51 patients (28%). At month 1 of treatment, viral persistence accurately predicted non-response (predictive value, 95.3 ; 95% confidence interval, 86.0-98.8 ; P<0.0001).
Independent predictors of sustained response were undetectable viremia at the first month of therapy (P<0.001), undetectable viremia at the third month (P<0.001), younger age (P=0.006), nonsporadic infection (P=0.012), and higher pretreatment aspartate aminotransferase levels (P=0.032).
In patients who cleared HCV RNA at month 1 of therapy, the predicted probability of sustained response averaged 70% for those younger than 30 years and diminished by 10% for each decade of age.
Failure to clear HCV RNA at month 1 of treatment is strongly and independently associated with a very low probability of a sustained response to interferon.
Mots-clés Pascal : Hépatite virale C, Virose, Infection, Chronique, Etude comparative, Interféron, Facteur prédictif, Efficacité traitement, Virémie, Evaluation, Homme, Latence réponse, Appareil digestif pathologie, Foie pathologie, Cytokine, Organisation santé
Mots-clés Pascal anglais : Viral hepatitis C, Viral disease, Infection, Chronic, Comparative study, Interferon, Predictive factor, Treatment efficiency, Viremia, Evaluation, Human, Response latency, Digestive diseases, Hepatic disease, Cytokine, Public health organization
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0002139
Code Inist : 002B05C02G. Création : 17/04/1998.