Interferon For Chronic Hepatitis Research Articles

Ribavirin monotherapy for chronic hepatitis C

Hepatitis C is a major cause of liver-related morbidity and mortality. A high proportion of patients never experience symptoms. Peginterferon plus ribavirin is the recommended treatment for chronic hepatitis C. However, ribavirin monotherapy may be considered for some patients. To assess the beneficial and harmful effects of ribavirin monotherapy for patients with chronic hepatitis C. We identified trials through electronic databases, manual searches of bibliographies and journals, authors of trials, and pharmaceutical companies until March 2009. We included all randomised trials irrespective of blinding, language, or publication status comparing ribavirin versus no intervention, placebo, or interferon for chronic hepatitis C. The primary outcome measures were serum sustained virological response (loss of hepatitis C virus RNA at least six months after treatment), liver-related morbidity plus all-cause mortality, and adverse events. Secondary outcome measures were end of treatment virological response, biochemical response (transaminase activity), and histological response. Randomisation methods, blinding, data handling, and funding were extracted as measures of bias control. Random-effects and fixed-effect meta-analyses were performed for all outcomes. We only present the results of the fixed-effect model if both models provide the same result regarding statistical significance. We present data as risk difference (RD) with 95% confidence intervals (CI). We included 14 randomised trials with 657 patients. The majority of trials had unclear control of bias. Compared with placebo or no intervention, ribavirin had no significant effect on the sustained virological response (RD 0%, 95% CI -2% to 3%, five trials) or end of treatment virological response (RD 0% 95% CI -3% to 3%, ten trials). Ribavirin had no significant effect on liver-related morbidity plus mortality (RD 0%, 95% CI -2% to 3%, 11 trials). Ribavirin significantly increased the risk of adverse reactions, including anaemia. Ribavirin significantly improved end of treatment biochemical and histological response but not the sustained biochemical response. Ribavirin was significantly inferior to interferon regarding virological and biochemical responses (five trials). Ribavirin seems without beneficial effects on serum virological response and liver-related morbidity or mortality, and significantly increased the risk of adverse reactions. Ribavirin monotherapy seems significantly inferior to interferon monotherapy. The total number of included patients is small, and more trials are perhaps needed. The use of ribavirin monotherapy for chronic hepatitis C cannot be recommended outside randomised trials.

Pegylated Interferon Associated Retinopathy in Chronic Hepatitis Patients

Purpose: To investigate clinical features of pegylated interferon‐associated retinopathy in chronic hepatitis patients. Methods: The present study was a consecutive case series of 46 patients who were treated with pegylated interferon for chronic hepatitis C or B from October 2007 to September 2008 in our hospital. The patients had a regular ophthalmologic examination every 3 weeks for 6 months after treatment. Results: Out of 46 patients, 10 patients (21.73%) developed retinal abnormality. Pegylated interferon‐associated retinopathy occurred at 7.2510.28 weeks after the treatment with cotton‐wool spots and retinal hemorrhage. All cases except one mild nonproliferative diabetic retinopathy case presenting broad perimacular non‐perfusion recovered without cessation of the treatment. Conclusions: Pegylated interferon‐associated retinopathy in chronic hepatitis patients was reversible and had a recovery without visual complication. However, a single case did present with irreversible visual impairment. Pegylated interferon‐associated retinopathy is usually asymptomatic and clinicians should observe patients closely for 3 months after treatment.

OL-018 Efficacy of interferon for chronic hepatitis B patients with normal or paranormal ALT

OL-018 Efficacy of interferon for chronic hepatitis B patients with normal or paranormal ALT

Marked Flare in Hepatic Aminotransferases During Treatment with Pegylated Interferon for Chronic Hepatitis C, Genotype 2: A Case Report

Chronic hepatitis C (CHC) is the most common cause of chronic liver disease and is the leading cause of liver transplantation in the United States [1, 2]. It is a progressive disease that can lead to cirrhosis, liver failure, hepatocellular carcinoma, and death [1, 2]. Hence, it is very important that the disease be treated in its early stages, with the goal of obtaining sustained virologic response, which will effectively reduce the morbidity and mortality associated with this disease. The currently approved therapy for CHC is pegylated interferon plus ribavirin for 24 weeks or 48 weeks, based upon genotype [3]. The use of pegylated interferon and ribavirin combination therapy is associated with many side effects, and close monitoring of patients is required while they are on the therapy. We report an unusual case of marked flares in hepatic aminotransferases during each of two consecutive courses of pegylated interferon and ribavirin therapy for CHC genotype 2. There are very limited published data on the hepatotoxicity or liver enzyme flares associated with interferon therapy. In earlier data from a large retrospective study performed on 11,241 patients with chronic viral hepatitis (80% being CHC) treated with alfa interferon, only four patients had fatal side effects due to liver failure, and all four patients demonstrated a significant rise in aminotransferase levels [4]. It is possible that large, prospective, clinical trials may have revealed individual cases similar to our case but were not individually reported. Interferon maintenance trials, such as Hepatitis C Antiviral Long-term Treatment Against Cirrhosis (HALT-C) and Colchicine versus Peg-Intron Long-Term (COPILOT) may ultimately demonstrate transient alanine aminotransferase (ALT) flares, but these include predominantly nonresponder subjects and have not yet been published. Moreover, natural flares of serum ALT values in CHC patients are not very well-defined.

W1008 Outcome of Chronic Hepatitis C Patients Referred for Pre Therapy Psychiatric Evaluations

Background: Most physicians obtain psychiatric assessments in at-risk patients before prescribing interferon in chronic hepatitis C(HCV). The clinical impact of these assessments is not well characterized in clinic settings. Aims: This study was designed to evaluate the impact of pre treatment psychiatric evaluations and interventions on the treatment outcomes in a cohort of psychiatric-risk HCV patients. Method: Medical records of 119 HCV patients who were referred for pre therapy psychiatric evaluations were reviewed retrospectively. Reasons for referral, psychiatrists' diagnosis and recommendations were obtained. These data were correlated with viral, demographic and treatment data of individual patients. Results: Of the 119 patients, 61.3% were males. Mean age was 39.7 years (range 39.7-72.0). 73.9% were past intravenous drug users. 4.2% were of Asian origin. Genotype 1 accounted for 32.7%. 68.7% of treated patients were treated with pegyated interferon and ribavirin. 26.9% had a suspected current psychiatric symptom or illness which led to the referral. 63.9% had only a past psychiatric illness. 9.2% were referred as a routine. Most common reason for referral was either current or past history of depression (21.8% and 57.1% respectively). Current or past anxiety was present in 5% and 10.1% patients. Past history of psychosis present in 8.4% in patients. 40.6% of patients who were referred as having current psychiatric illness had a formal current psychiatric diagnosis at the psychiatric consultation. Only 25% of patients with past psychiatric illness had a formal current psychiatric diagnosis. Overall 72.3% had no current psychiatric condition. The common psychiatric condition diagnosed was depression at 13.2% followed by anxiety 4.2%. 26.9% were recommended to have regular psychiatric follow ups. 9.2% were prescribed anti psychiatric medications. 6.7%were recommended to defer their HCV therapy. Table 1 Conclusions: HCV patients with current psychiatric diagnosis had significantly higher number of psychiatric side effects and psychiatric interventions. But they could be treated without significant reduction in SVR rates. Table1: Treatment Outcomes

Liver derived endogenous opioids may interfere with the therapeutic effect of interferon in chronic hepatitis C

A substantial number of patients with chronic hepatitis C does not respond to treatment with interferon and ribavirin, the approved drugs to treat this viral infection. In vitro studies have shown that morphine, which exerts its effects by binding to opioid receptors, enhances the expression of hepatitis C RNA in hepatitis C-replicon containing liver cells, and that it interferes with the antiviral effect of interferon on the hepatitis C virus. Met-enkephalin, one of the endogenous opioid peptides, can bind to the same receptors to which morphine binds, triggering similar receptor-mediated effects. The liver in cholestasis can express Met-enkephalin immunoreactivity (MEIR). MEIR can also be detected in the liver of some patients with chronic hepatitis C. This finding suggests that Met-enkephalin is produced by or that it accumulates in the liver of patients with this viral hepatitis. Analogous to the effect of morphine on the hepatitis C-replicon containing liver cells, we hypothesize that Met-enkephalin enhances the replication of the hepatitis C virus in liver cells, and that it interferes with the antiviral effect of interferon, contributing to the lack of efficacy of this medication in the treatment of this viral infection in some patients. If this hypothesis is correct, the study of opiate antagonists in combination with antiviral therapy in patients with hepatitis C expressing MEIR in their livers merits consideration.

Pegylated interferon for chronic hepatitis B

Pegylated interferon for chronic hepatitis B

Hepatitis C Virus Infection and Depression

Approximately 170 million people worldwide suffer from chronic hepatitis C. Depression is more prevalent among people with chronic viral hepatitis C as compared to the normal population; it can be identified in about 58% of patients. Based on the literature, the authors review the aetiology of depression occurring in hepatic disease, with regard to the neuropathogenic activity of hepatitis C virus (HCV). They report research results that may serve as evidence for alterations caused by the hepatitis C virus in the central nervous system. Depression is one of the side effects of interferon-α used for treating HCV infection. The authors discuss the biologic bases, the development and the consequences of depression caused by interferon in chronic hepatitis C, and they review the course of assessing patients with depression. They summarise the steps of psychiatric pharmacotherapy in chronic liver diseases. It is important to consider, whether a patient with chronic hepatitis C and depression can be treated with interferon. Missing interferon therapy may lead to a fatal outcome of the hepatic disease. In order to come to a prudent decision an appropriate cooperation is needed between physician and psychiatrist.

Advances in chronic viral hepatitis

Chronic liver disease due to hepatitis B virus or hepatitis C virus infection results in cirrhosis and hepatocellular carcinoma. Successful eradication or suppression of viral replication may lead to clinical improvement and better prognosis. Important discoveries have been made in recent years on the management of these diseases. This article aims at reviewing important publications of the past year that contribute to better understanding and treatment of chronic viral hepatitis. The effect of virus genotype on the natural history continued to be an important topic of research. Landmark studies on the use of pegylated interferon in chronic hepatitis B and benefit of antiviral treatment in patients with advanced fibrosis or cirrhosis have been published. New antiviral agents were evaluated with encouraging results. In chronic hepatitis C, several treatment trials using pegylated interferon on HIV-coinfected patients have been published. Treatment in specific groups of patients, including those with normal alanine transaminase or posttransplantation recurrence, has also been investigated. Major progress has been made in the treatment of chronic hepatitis B and pegylated interferon is likely to become one of the first-line therapeutic options in the near future. Combined pegylated interferon and ribavirin will be the standard treatment regimen for hepatitis C and HIV coinfection. Future challenges include treatment of hepatitis B and HIV coinfection and discovery of more potent antiviral agents.

Pegylated Interferon vs Standard Interferon for Chronic Hepatitis C—Reply

Pegylated Interferon vs Standard Interferon for Chronic Hepatitis C—Reply

Insulin resistance impairs sustained response rate to peginterferon plus ribavirin in chronic hepatitis C patients

We evaluated the effect of insulin resistance and viral factors on sustained virological response in patients with chronic hepatitis C treated with peginterferon plus ribavirin. Patients (n=159; 94 men; age, 41.7 +/- 11.1 years) with chronic hepatitis C (genotype 1, n=113; non-1 genotype, n=46) received treatment with interferon plus ribavirin. Serum levels of leptin and insulin were measured, and the insulin resistance index (HOMA-IR: homeostasis model of assessment) and body mass index were calculated. A sustained virological response was associated with lower age, insulin resistance index, body mass index, and gamma-glutamyltranspeptidase and serum leptin levels. There was no association with viral load, sex, type of interferon, or cholesterol levels. A sustained virological response was achieved in 43.4% (46/113) of genotype 1 and 89% (32/36) of genotype 2 and 3 (P=.0001) patients. Necroinflammatory activity and steatosis were not associated with the sustained virological response rate. Multivariate regression analysis indicated that the independent variables related to sustained virological response were genotype (odds ratio, 3.57; 95% confidence interval, 1.49-8.3; P=.001), insulin resistance index (odds ratio, 1.82; 95% confidence interval, 1.08-3.06; P=.012), and fibrosis (odds ratio, 1.36; 95% confidence interval, 1.01-1.84; P=.029). A sustained virological response in patients with genotype 1 and insulin resistance (HOMA-IR > 2) occurred in 23 of 70 (32.8%; 95% confidence interval, 21.9%-43.9%) patients, vs. 26 of 43 (60.5%; 95% confidence interval, 45.9%-75.1%) genotype 1 patients without insulin resistance (P=.007; odds ratio, 3.12, 95% confidence interval, 1.42-6.89). Insulin resistance, fibrosis, and genotype are independent predictors of the response to antiviral therapy in chronic hepatitis C patients treated with peginterferon plus ribavirin.

Advances in hepatitis B and C.

Hepatitis B and C infections are prevalent around the world and a major health burden due to the associated complications of hepatic fibrosis, cirrhosis and hepatocellular carcinoma which occur in the context of chronic infection. Significant advances are being made in assessing and treating infected patients and recent studies are now targeting patients who have failed to respond to previous treatments or who have associated co-morbidities. The purpose of this article to review the recent literature on the subject of hepatitis B and C infections with particular focus on new treatment options, new approaches in patients who have previously failed therapy and in those who have co-morbidity. A large number of studies have been carried out investigating the roles of varying doses, targeting treatment in particular groups and new treatment options in patients infected with hepatitis B and C. Several key findings such as the value of prolonging treatment in patients with genotype 1 hepatitis C infection, the use of pegylated interferon in chronic hepatitis B infection and the emergence of new treatments such as adefovir for resistant hepatitis B infection, as well as treatment of patients co-infected with hepatitis C and human immunodeficiency virus, have dominated the recent literature. Patients in particular groups such as those who have had liver transplantation or who are immunosuppressed have also received added attention. Hepatitis B and C infections are the focus of much current attention with particular regard to new and emerging treatment options which are becoming increasingly focused on varying patient groups.

Characteristics of patients with chronic hepatitis C who develop hepatocellular carcinoma after a sustained response to interferon therapy.

The objective of the current study was to determine the characteristic features of sustained responders who develop hepatocellular carcinoma after treatment with interferon for chronic hepatitis C. This study included 3626 patients with chronic hepatitis C who had received interferon monotherapy. Cox proportional hazards analysis was used to compare sustained responders who did and did not develop hepatocellular carcinoma, and nonsustained responders who developed hepatocellular carcinoma in a multicenter, retrospective cohort study. Among 1197 sustained responders, 27 patients developed hepatocellular carcinoma (2.3%). Compared with sustained responders who did not develop hepatocellular carcinoma, patients who developed disease more often were male (P = 0.0212), were older (P = 0.0068), and had advanced-stage histologic disease before interferon therapy (P = 0.0345). Conversely, compared with patients with hepatocellular carcinoma who were not sustained responders, patients who were sustained responders tended to be older at the time of the initiation of interferon therapy (P = 0.0552) and at the time hepatocellular carcinoma was detected (P = 0.0593), and they also were predominantly male (P = 0.0507). The histologic staging and serum aminotransferase levels at the initiation of interferon therapy, the interval to the detection of tumor, and the tumor size showed no significant differences between the two groups. Sustained responders in the group at high risk for developing hepatocellular carcinoma after interferon therapy were older, more often were male, and had more advanced histologic disease stage. Such patients should be followed carefully periodically for > 10 years after they complete interferon therapy.

Randomized trial of prolonged interferon retreatment for chronic hepatitis C patients with HCV-genotype 1b and high virus load

The aim of this study was to examine whether 78 week course of interferon (IFN) retreatment could improve the beneficial effect of IFN in chronic hepatitis C patients compared with 52 week course of IFN retreatment. Inclusion criteria were biopsy-proven chronic hepatitis, serum HCV–RNA level of more than 1 Meq/ml, HCV-genotype 1b, abnormal serum alanine aminotransferase (ALT), and transient negative conversion for HCV–RNA during the initial course of IFN therapy. Forty-one patients were randomly assigned to two groups, receiving total doses of: 1410 MU for 52 weeks (a 52 week-group: n=20), or 1995 MIU for 78 weeks (a 78 week-group: n=21). But three patients (one in the 52 week-group and two in the 78 week-group) were withdrawn from the study due to a transfer, refusal after randomization, and occurrence of malignant lymphoma before IFN retreatment, respectively. Therefore remainder 38 patients were studied about efficacy of IFN administration. A virological response (VR) to IFN therapy was defined as HCV–RNA negativity by the reverse transcription nested polymerase chain reaction both 3 and 6 months after the completion of IFN retreatment. A biochemical response (BR) was defined as normalization of ALT but positive HCV–RNA both 3 and 6 months after the cessation of IFN therapy. According to these criteria, VR was 36.8% (7/19) in the 52 week-group and 21.1% (4/19) in the 78 week-group. BR was 5.3%(1/19) in the 52 week-group and 21.1% (4/19) in the 78 week-group. There was no significant difference between the 52 week-group and the 78 week-group with respect to the effect of IFN. We conclude that 52 week course of IFN retreatment may be a sufficient strategy if patients, who have HCV-genotype 1b and high virus load, show negative HCV–RNA and normal ALT level during the first IFN therapy.

Radix Sophorae flavescentis for chronic hepatitis B: a systematic review of randomized trials.

To evaluate the effects of radix Sophorae fiavescentis for chronic hepatitis B, a systematic review of randomized clinical trials was conducted. Randomized trials comparing extract of radix Sophorae flavescentis versus placebo, no intervention, non-specific treatment, other active medicines, or interferon for chronic hepatitis B were identified by electronic and manual searches. Trials of Sophorae herb plus other drugs versus other drugs alone were also included. No blinding and language limitations were applied. The methodological quality of trials was assessed by the Jadad scale plus allocation concealment. Meta-analysis was performed where data was available. Twenty-two randomized trials (n = 2409) were included. Methodological quality of the trials was generally low. The combined results showed that matrine (aqueous extract of Sophorae flavescentis) had antiviral activity, positive liver biochemical effects, and improved symptoms and signs compared with non-specific treatment and other herbal medicines. The combination of matrine and interferon-alpha (IFN-alpha), thymosin, or basic treatment showed better effects on viral and liver biochemical responses. The antiviral and biochemical responses were not significantly different between matrine and IFN-alpha. No serious adverse event was reported. Based on the review, Sophorae flavescentis extract (matrine) may have antiviral activity and positive effects on liver biochemistry in chronic hepatitis B. However, the evidence is not sufficient to recommend matrine for routine clinical use due to the generally low methodological quality of the studies. Further rigorous trials are needed.

Interferon for interferon nonresponding and relapsing patients with chronic hepatitis C.

Interferon monotherapy leads to sustained virologic clearance in a minority of patients with chronic hepatitis C. Studies have yielded conflicting results regarding retreatment with interferon in nonresponders and relapsers. To assess the beneficial and harmful effects of retreatment with interferon in chronic hepatitis C nonresponders and relapsers to previous interferon treatment. Trials were identified through electronic databases, manual searches, authors, and pharmaceutical companies (August 2001). Randomised trials comparing interferon versus control or different interferon regimens in chronic hepatitis C patients being nonresponders and relapsers to previous interferon were included. The primary outcome was failure to achieve a sustained virologic response defined as positive serum hepatitis C virus RNA at least six months following treatment. Secondary outcomes included liver-related morbidity, mortality, biochemical responses, adverse events, and histology. Ten randomised trials involving 686 nonresponders and eight trials involving 484 relapsers were included; their methodological quality was poor. In nonresponders, interferon reduced the risk of not achieving an end of treatment biochemical response compared with no treatment (relative risk [RR] 0.77, 95% confidence interval [CI] 0.66 to 0.91); however, virologic responses were not reported. In a post hoc subgroup analysis, doses greater than 3 million units (MU) three times weekly offered no advantage compared with 3 MU three times weekly for biochemical sustained response. Failure to obtain a virologic sustained response was less likely with 48 than 24 weeks of therapy (RR 0.87, 95% CI 0.79 to 0.96). Adverse events did not differ significantly regardless of treatment dose or duration. In relapsers, none of the trials compared interferon with no treatment. In a post hoc analysis, doses greater than 3 MU three times weekly were no more effective in achieving a virologic sustained response than 3 MU three times weekly. Compared with 24 weeks, treatment durations of 48 weeks were less likely to fail to achieve a virologic sustained response (RR 0.69, 95% CI Random 0.51 to 0.95), but associated with more frequent dosage reduction (RR 9.07, 95% CI 1.20 to 68.63). No data regarding clinical outcomes or histology was available in either patient group. Retreatment with interferon leads to sustained virologic clearance in a minority of chronic hepatitis C patients with nonresponse or relapse following interferon monotherapy. Treatment durations of 48 weeks are superior to 24 weeks, but doses greater than 3 MU three times weekly are no more effective. No data exists regarding the effect on clinical outcomes.

Significant pulmonary toxicity associated with interferon and ribavirin therapy for hepatitis C

OBJECTIVE: The aim of this study was to analyze the clinical presentation and outcomes of significant pulmonary toxicity associated with interferon and ribavirin. METHODS: We conducted a retrospective review of patients enrolled in four clinical trials at three sites, two academic medical centers and one community practice, and reviewed the literature. RESULTS: Four patients, while on therapy with interferon α and ribavirin for chronic hepatitis C, developed significant pulmonary signs and symptoms. Further workup, which included lung biopsy in three, revealed bronchiolitis obliterans organizing pneumonia in two, and interstitial pneumonitis in two other cases. There were no other predisposing factors for lung disease identified. Resolution of symptoms occurred in all patients upon discontinuation of interferon and ribavirin, with or without corticosteroid therapy. One of the patients developed pulmonary complications while on a clinical trial of pegylated interferon and represents the first reported case associated with the use of long-acting interferon in chronic hepatitis C infection. CONCLUSIONS: A spectrum of significant pulmonary toxicity, including bronchiolitis obliterans organizing pneumonia and interstitial pneumonitis, can occur with interferon or pegylated interferon in combination with ribavirin. Though pulmonary toxicity of interferon is well known, these cases represent the first cases reported in the literature with combination therapy. It is likely that pulmonary toxicity may not be investigated in patients on combination therapy because of the frequent pulmonary symptoms with ribavirin. Though usually reversible, at least one case has required long-term steroids with inadequate resolution. Though pulmonary toxicity is rare, symptoms which are more than mild or progressive in nature should likely be investigated.

African Americans with genotype 1 treated with interferon for chronic hepatitis C have a lower end of treatment response than Caucasians.

African Americans as a group have a higher incidence of chronic hepatitis C (CHC) than Caucasians but are often under-represented in clinical trials used to define response rates to interferon therapy. The aim of this study was to compare African Americans with Caucasians with respect to end-of-treatment response to interferon. This retrospective study had 61 African Americans and 49 Caucasians with CHC. All patients were treated for at least 12 weeks with interferon-alpha2b (Intron A) thrice weekly. End-of-treatment response was defined as three consecutive nondetectable HCV RNA measurements at least 1 month apart. Sustained response was defined as a negative serum HCV RNA 6 months after end of treatment. Of the 110 patients, 19 achieved an end-of-treatment response (17%) but only four achieved a sustained response (4/110=4%). Of the patients achieving a sustained response, one was genotype 1 (male Caucasian), three were genotype 2/3 with four patients having no follow-up information. The end-of-treatment response was 7% for patients with genotype 1 and 71% for genotype non-1 (P < 0.005 for genotype non-1). The end-of-treatment response was significantly higher in Caucasians (14/49=31%) compared with African Americans (5/61=8%; P < 0.05). A lower response rate in African Americans with genotype 1 in contrast to Caucasians was the primary reason for the difference in end-of-treatment response (1/45=2% vs. 5/33=15%, P < 0.05). Hence, interferon treatment resulted in a poor sustained response rate in the group of patients representative of the urban populations with the highest prevalence of hepatitis C. A genotype other than type 1 was the strongest predictor of end-of-treatment response in patients treated but over 86% of patients in this urban clinic were genotype 1. Caucasians were more likely to respond than African Americans, especially in patients with genotype 1.

Factors predicting interferon treatment response in patients with chronic hepatitis C: late viral clearance does not preclude a sustained response

OBJECTIVES: Because of the suboptimal efficacy, cost, and adverse effects of interferon in chronic hepatitis C (HCV), predictors have been sought to detect patients with a good treatment response. Also, markers for determining a poor response early in the course of therapy, such as the lack of early viral clearance, have been proposed. METHODS: Ninety-seven patients with chronic hepatitis C were enrolled to receive leukocyte α-interferon according to a stepped-care management protocol. The final virological treatment response was evaluated in 74 patients after a 6-month post-treatment follow-up. The relationship between pretreatment and during-treatment variables and the long-term response was assessed. RESULTS: Non-1 viral genotype, higher pretreatment ALT levels, and lower γ-glutamyl transferase (GGT)/ALT ratios and GGT as well as younger age were significantly associated with a sustained response; a trend was also detected for lower serum ferritin levels. Normalization of ALT by 3 months was also a significant predictor of a long-term response. Of the 27 patients carrying the HCV genotype 3a, seven (26%) were still HCV RNA positive at 6 months. Of these patients, however, five (19%) still achieved a sustained virological response after treatment for up to 12 months. CONCLUSIONS: In contrast to some previous reports, our results suggest that a late viral clearance after 6 months of interferon monotherapy may not preclude a favorable long-term response after a 12-month treatment, especially in patients carrying a non-1 HCV genotype. A low pretreatment GGT/ALT ratio is a predictor of a good treatment response.

A case of ulcerative colitis along with characteristic features on computed tomography (CT), developed by the treatment with interferon for chronic hepatitis C

A case of ulcerative colitis along with characteristic features on computed tomography (CT), developed by the treatment with interferon for chronic hepatitis C