Journal of Gastroenterology

, Volume 46, Issue 12, pp 1427–1436

The determination of GGT is the most reliable predictor of nonresponsiveness to interferon-alpha based therapy in HCV type-1 infection

  • Viola Weich
  • Eva Herrmann
  • Tje Lin Chung
  • Christoph Sarrazin
  • Holger Hinrichsen
  • Peter Buggisch
  • Tilman Gerlach
  • Hartwig Klinker
  • Ulrich Spengler
  • Alexandra Bergk
  • Stefan Zeuzem
  • Thomas Berg
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-011-0458-y

Cite this article as:
Weich, V., Herrmann, E., Chung, T.L. et al. J Gastroenterol (2011) 46: 1427. doi:10.1007/s00535-011-0458-y
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Abstract

Background

The critical analysis of baseline factors has been found to be useful to predict virologic nonresponse (NR), relapse, or sustained virologic response (SVR) in patients infected with hepatitis C virus (HCV) who receive antiviral therapy. In the present retrospective study we tried to find out whether gamma-glutamyltranspeptidase (GGT) may be one of the baseline factors which are of special predictive power. We analyzed, in patients with different treatment outcomes, the predictive power of established baseline factors either in combination with GGT or by evaluating the predictive value of GGT independently.

Methods

Individual data from 632 patients chronically infected with HCV type 1 (n = 561) or type 2/3 (n = 71) were analyzed. All patients had received their first course of antiviral therapy and were treated with pegylated interferon α-2a or -2b plus ribavirin.

Results

In patients with HCV type 1, a multivariate multinomial logistic regression analysis identified low GGT (p < 0.0001), high cholesterol (p < 0.0001), age ≤40 years (p < 0.0001), high alanine aminotransferase (p = 0.0006), low viremia (p = 0.0014), and absence of cirrhosis (p = 0.0164) as independent predictors. While these baseline factors heralded improved virologic response, high GGT, in contrast, was significantly associated with NR (p < 0.0001). A strong correlation was found between log10 GGT and a scoring variable S (r = −0.26 for prediction of SVR, p < 0.001; r = 0.11 for prediction of NR, p = 0.016) summarizing predictive information from other baseline factors.

Conclusions

These findings prove the predictive sensitivity of GGT as an independent indicator of nonresponsiveness even at levels that are slightly above the normal range. This new predictive parameter may help to improve individualized therapy in HCV type-1 infection.

Keywords

Antiviral therapyBaseline factorsVirologic nonresponseEnd-of-treatment responseSustained virologic response

Abbreviations

HCV

Hepatitis C virus

IFN

Interferon

RBV

Ribavirin

GGT

Gamma-glutamyltranspeptidase

ALT

Alanine aminotransferase

AST

Aspartate aminotransferase

AP

Alkaline phosphatase

WBC

White blood count

IgA

Immune globulin A

pCHE

Pseudocholinesterase

BMI

Body mass index

SVR

Sustained virologic response

SR

Sustained response

NR

Nonresponse

EOT

End-of-treatment virologic response

RNA

Ribonucleic acid

DNA

Deoxyribonucleic acid

bDNA

Branched DNA

ROC

Receiver operating characteristics

ULN

Upper limit of normal

S

Scoring variable

TNF-α

Tumor necrosis factor-α

ETR

End-of-treatment virologic response

Copyright information

© Springer 2011

Authors and Affiliations

  • Viola Weich
    • 1
    • 3
  • Eva Herrmann
    • 2
  • Tje Lin Chung
    • 2
  • Christoph Sarrazin
    • 3
  • Holger Hinrichsen
    • 4
  • Peter Buggisch
    • 5
  • Tilman Gerlach
    • 6
  • Hartwig Klinker
    • 7
  • Ulrich Spengler
    • 8
  • Alexandra Bergk
    • 1
  • Stefan Zeuzem
    • 3
  • Thomas Berg
    • 1
    • 9
  1. 1.Universitätsklinikum Charité, Campus Virchow-KlinikumUniversitätsmedizin BerlinBerlinGermany
  2. 2.Institut für Biostatistik und mathematische ModellierungGoethe-Universität FrankfurtFrankfurtGermany
  3. 3.Medizinische Klinik 1Klinikum der Goethe-Universität FrankfurtFrankfurtGermany
  4. 4.Universitätsklinikum Schleswig-HolsteinKielGermany
  5. 5.Universitätsklinikum EppendorfHamburgGermany
  6. 6.Klinikum Augustinum MünchenMünchenGermany
  7. 7.Medizinische Klinik und Poliklinik II der Universität WürzburgWürzburgGermany
  8. 8.Medizinische Universitätsklinik IIBonnGermany
  9. 9.Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Sektion HepatologieUniversitätsklinikum LeipzigLeipzigGermany