Extent of Liver Injury as a Predictor of Response to Interferon Combination Therapy

Background: To determine the value of extent of liver injury as a baseline predictor of response to conventional interferon plus ribavirin for chronic hepatitis C Genotype 3 .Methods: In this descriptive study treatment naive hepatitis C patients (n=489) underwent serum Alanine Aminotransferase (ALT) measurement and a liver biopsy to assess for hepatic steatosis and Histology Activity Index (HAI). Six months conventional interferon plus ribavirin therapy was given to all and the significance of above mentioned parameters as predictors of response in terms of Sustained Virological Response (SVR) and End of Treatment Response (ETR) was analyzed. Chi-square test and regression analysis were used to calculate the results with a significant P value < 0.05.Results: Male individuals constituted 31.1% (n=152) of the population while 68.9% (n=337) were females. Mean Alanine Aminotransferase level was 73.74 ± 65.27 IU/l.SVR was achieved by 61% (n=298) individuals while ETR by 83.4% (n=408). Mild hepatic inflammation and fibrosis i-e-, low HAI (≤8) turned out to be a significant predictor of both a good ETR (p=0.00) and SVR (p=0.00). Minimal to mild degree of steatosis (≤33%) was a predictor of better SVR (0.00). Baseline ALT level was not significantly associated with response rate (p=0.76).Conclusion: Lower extent of hepatic steatosis (≤33%) and low HAI (≤8) is a significant predictor of better response to conventional interferon combination therapy for HCV Genotype 3. Hepatic steatosis >66% and HAI > 12 predicts failure to respond