Patients with chronic hepatitis C (n=103) were treated for 24 weeks with interferon alia 2b and followed up for 24 weeks after cessation of therapy (week 48).
When hepatitis C virus (HCV) RNA at week 48 was used to assess interferon response, 15 (14.6%) were virological complete responders, and all have remained HCV RNA negative for a mean of 3 years.
At week 48,3 of 15 virological complete responders had elevated alanine transaminase (ALT) values.
When serum ALT level was used at week 48 to determine response to interferon, 20 (19.4%) were biochemical complete responders.
However, 8 of the 20 patients with normal ALT levels were HCV RNA positive at week 48, and 7 of these individuals have had a recurrence of elevated ALT levels within 3 years after cessation of treatment.
These findings indicate that measurement of HCV RNA was more accurate than ALT in determining true responses to interferon therapy.
Identification of nonresponders early during the course of interferon treatment showed that an elevated ALT level at week 12 was 92% predictive (odds ratio 3.7) but misidentified 33% (5 of 15) of the patients who were virological complete responders at week 48.
In contrast, a positive HCV RNA at week 12 of treatment was 98% predictive (odds ratio 35.5) and misidentified only 6.7% (1 of 15) of the virological complete responders. (...)
Mots-clés Pascal : Hépatite virale C, Virose, Infection, Chronique, Traitement, Immunothérapie, Interféron alpha, Valeur prédictive, Réponse, Dosage, RNA, Virus hépatite C, Hepacivirus, Flaviviridae, Virus, Activité enzymatique, Alanine transaminase, Transaminases, Transferases, Enzyme, Etude comparative, Homme, Appareil digestif pathologie, Foie pathologie, Economie santé
Mots-clés Pascal anglais : Viral hepatitis C, Viral disease, Infection, Chronic, Treatment, Immunotherapy, Alpha interferon, Predictive value, Response, Assay, RNA, Hepatitis C virus, Hepacivirus, Flaviviridae, Virus, Enzymatic activity, Alanine transaminase, Transaminases, Transferases, Enzyme, Comparative study, Human, Digestive diseases, Hepatic disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0051966
Code Inist : 002B02Q. Création : 14/05/1998.