Journal of Gastroenterology

, Volume 46, Issue 11, pp 1335–1343

Efficacy of pegylated interferon plus ribavirin combination therapy for hepatitis C patients with normal ALT levels: a matched case–control study

Authors

    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Yuko Inoue
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Tsugiko Oze
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Nao Kurashige
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Takayuki Yakushijin
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Kiyoshi Mochizuki
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Takuya Miyagi
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Tomohide Tatsumi
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Shinichi Kiso
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Tatsuya Kanto
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Akinori Kasahara
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Tetsuo Takehara
    • Department of Gastroenterology and HepatologyOsaka University Graduate School of Medicine
  • Masahide Oshita
    • Osaka Police Hospital
  • Eiji Mita
    • National Hospital Organization Osaka National Hospital
  • Hideki Hagiwara
    • Kansai Rosai Hospital
  • Yoshiaki Inui
    • Hyogo Prefectural Nishinomiya Hospital
  • Kazuhiro Katayama
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
  • Shinji Tamura
    • Minoh City Hospital
  • Harumasa Yoshihara
    • Osaka Rosai Hospital
  • Yasuharu Imai
    • Ikeda Municipal Hospital
  • Norio Hayashi
    • Kansai Rosai Hospital
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-011-0455-1

Cite this article as:
Hiramatsu, N., Inoue, Y., Oze, T. et al. J Gastroenterol (2011) 46: 1335. doi:10.1007/s00535-011-0455-1

Abstract

Background

The antiviral effect of pegylated interferon (Peg-IFN) plus ribavirin combination therapy in chronic hepatitis C (CHC) patients with normal alanine aminotransferase (ALT) levels (N-ALT) has been reported to be equivalent to that for patients with elevated ALT levels (E-ALT). However, the actual antiviral effect in N-ALT patients remains obscure because efficacy can be overestimated in patients with an advantageous background.

Methods

In this study, 386 patients were extracted, for a matched case–control study, from 1320 CHC patients treated with Peg-IFN alpha-2b plus ribavirin combination therapy; 193 N-ALT patients [116 with hepatitis C virus genotype 1 (HCV-1), 77 with HCV genotype 2 (HCV-2)] were matched with 193 E-ALT patients by a propensity score method using the variables of age, sex, IFN treatment history, body mass index, and platelet counts.

Results

On multivariate analysis for sustained virological response (SVR) in N-ALT patients, younger age, low HCV RNA level at baseline, and HCV-2 were significant factors. The matched case–control study showed that the SVR rates of N-ALT patients were equivalent to those of E-ALT patients; at 49 and 40% in the HCV-1 group (P = 0.146), and 78 and 81% in the HCV-2 group (P = 0.691). However, in N-ALT patients with non-SVR, approximately 40% showed ALT elevation at 24 weeks post-treatment.

Conclusion

Our findings indicate that the antiviral effect of Peg-IFN plus ribavirin therapy in N-ALT patients is comparable to that for E-ALT patients irrespective of their advantageous background; however, the application of this therapy for N-ALT patients, especially for those with HCV-1, should be considered carefully.

Keywords

Hepatitis C virusNormal alanine aminotransferasePegylated interferon plus ribavirin combination therapyPropensity score methodMatched case–control study

Copyright information

© Springer 2011