Factors influencing the response of interferon therapy in chronic hepatitis C patients

To determine factors influencing response of interferon therapy in chronic hepatitis C patients. Descriptive, analytical study. Pakistan Medical Research Centre, Jinnah Postgraduate Medical Centre, Karachi, from January 1998 to December 2009. Patients of chronic hepatitis C treated with conventional interferon were retrospectively analyzed. End treatment response at 6 months for genotype 2 and 3 and one-year for genotype 1 and 4 was assessed. Sustained virological response was checked after 6 months of cessation of therapy. Non-compliant and incomplete follow-up cases were excluded. Factors influencing the response to therapy were analyzed by univariate and multivariate logistic regression analysis. A total of 932 cases received interferon therapy; 103 were lost to follow-up and were excluded. Treatment was completed in 829 cases; end treatment response was 74% [615 out of 829 cases]. Six months post-treatment follow-up was available in 492 cases. Sustained virological response was seen in 63% [308 out of 492 cases]. Univariate logistic regression analysis showed significantly better response in patients with < 40 years of age, body weight < 70 kg, normal platelet count, serum albumin > 4.0 grams, non diabetic patients and those with a normal alanine aminotransferase [ALT] at 1st month of therapy. Multiple logistic regression analysis showed that only age < 40 years was significantly important for sustained virological response. For conventional interferon therapy, age < 40 years is the best predictor for sustained virological response, however, better response can be achieved in patients with < 70 kg weight, normal platelet count, serum albumin > 4.0 grams, non-diabetics and patients having normal ALT at 1st month of therapy

Role of ursodeoxycholic acid in lowering ALT in chronic liver disease

The objective was to see the efficacy of ursodeoxycholic acid in improving the ALT levels in patients suffering from chronic liver disease. Thirty patients suffering from chronic liver disease [either B or C] were given oral ursodeoxycholic acid in a dose of 250 mg twice a day for 4 months. Their blood biochemistry and haematology were repeated monthly for 7 months i.e. 4 months of therapy and 3 months post therapy to see the response. The mean ALT levels of 30 patients who completed the study was 101+47 IU/L. During therapy 24 cases [80%] showed lowering of their ALT levels while 6 [20%] either showed no response or worsening of ALT levels. Of 24 cases who showed an improvement in their ALT levels; over 25% drop in ALT levels was seen in 217 cases [70%] and less than 25% drop seen in 7 cases [30%]. The mean ALT values during therapy were 75 IU/L showing an overall 25% reduction from the baseline values. Following cessation of therapy the mean ALT levels showed a rise to 90 IU/L which was almost similar to 101 IU/L value in the pre treatment period. The study showed some role of ursodeoxycholic acid in improving the ALT levels in chronic liver disease