Journal of Liver: Krankheit und Transplantation

Analysis of Pretreatment Predictors of a Virological Response to Interferon Therapy in Co-infected Patients of Hepatitis C and B

Maleha Asim, Amir Rashid, Asifa Majeed and Suhail Razak

Background: Several pretreatment parameters are strongly associated with sustained virological response rate (SVR) in HCV/ HBV co-infected patients.

Methods: We identified 104 HCV/HBV co-infected patients (69 males and 35 females) who were treated with standard interferon-alfa-2a or pegylated-IFN-alfa-2b by using electronic query. Data analysis includes their age, gender, clinical, hierological and histological parameters.Patients were divided into two groups of interferon responders (negative HCV RNA level) and non-responders (patients with positive HCV-RNA levels). Multivariate regression analysis was used to assess the effect of pre-treatment variables and therapy regime on sustained virological rate (SVR) in both groups.

Results: The pretreatment parameters significantly associated with sustained virological response to interferon therapy were low levels of serum ALT (p=0.002), HCV-RNA (˂4×105 IU/ml) (p=0.038), HBVDNA(˂2×104 IU/ml) (p=0.002), HCV genotype-3 (p=0.025) and IL- 28B CC genotype (p=0.049). As for histological factors, normal to minimal change in liver biopsy was found considerably associated with therapy response (p=0.024). Significant advantage of peginterferon plus ribavirin was also observed for SVR (p=0.004).Post-treatment HBV-DNA clearance was observed in 22% of 104 co-infected patients.

Conclusion: Pretreatment parameters are closely related with better response to therapy. Peg-interferon and ribavirin in combination is an effective regime significantly associated with SVR in HCV/HBV co-infected patients.