Dense packing of portal lymphocytes predicts favorable treatment outcome in hepatitis C

Background/Aims: To identify pre-therapeutic predictors of sustained virological response (SVR) in Taiwanese patients with chronic hepatitis C. Methodology: One hundred and ninety-eiglit consecutive patients receiving interferon plus ribavirin combination therapy were included. Stepwise logistic regression model was performed to estimate the SVR on the presence of various pre-therapeutic clinical parameters. Results: The difference of alanine aminotransferase and aspartate aminotransferase levels (β=0.0080, P=0.0151), the presence of genotype 1b (β=-1.9225, P<0,0001), the presence of dense packing of inflammatory cells in portal tract (β=1.5239, P=0.0354), age (β=-0.0441, P=0.0179) and pre-therapeutic HCV-RNA concentration (β = -0.0682, P=0.0411) were identified as independent predictors in the regression analysis. Patients with dense packing of inflammatory cells in portal tract (n=21) had significantly higher aspartate aminotransferase concentration, higher histology activity index, higher fibrosis score, and more histologically cirrhosis (P=0.032, 0.0001, 0.034, and 0.020, respectively). Paradoxically, they had a higher chance to achieve SVR (18/21 (85.7%) versus 99/177 (55.9%); P=0.017). Conclusions: Dense packing of inflammatory cells in portal tract is an independent predictor of SVR to antiviral therapy in patients with chronic hepatitis C.