Predictors of sustained virological response to combination therapy with interferon plus ribavirin for chronic hepatitis C

Chronic hepatitis C (CHC) infection may lead to liver cirrhosis and hepatocellular carcinoma in some of these patients over the years. Presently, combination therapy using interferon (IFN) and ribavirin is the standard treatment. Although its response rate is higher than IFN alone, it is expensive and the result is not very satisfactory. As such, the predictive factors for treatment outcome are important. In this study, we investigated the potential predictive factors for the treatment outcome. A total of 54 patients (22 female patients, 32 male patients; mean age: 47.2 ± 14.2 years) received combination therapy for 24 weeks, then followed up for 24 weeks. During treatment, patients received three million units of interferon α-2b subcutaneously three times a week, and ribavirin orally daily with the dose ranged from 1000 mg to 1200 mg. Forty-seven patients completed treatment and follow-up. The goal of treatment for CHC is to achieve sustained response (SR), which is defined as the absence of hepatitis C viral RNA in the serum 6 months after termination of treatment. The SR rate were 64.8% (35/54) (intension-to-treat) and 74.5% (35/47)(per protocol). Univariate analysis showed that genotype and pre-treatment HCV RNA levels correlated with the treatment outcome. Multivariate analysis showed that the genotype was the most significant predictive factor for treatment outcome. The SR rates for patients with non-genotype 1 infection and genotype 1 infection were 95.5% and 43.8% respectively. This result will help us in better patient selection in the future.