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Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

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Author(s)
Yun Jung KimByoung Kuk JangEun Soo KimKyung Sik ParkKwang Bum ChoWoo Jin ChungJae Seok Hwang
Keimyung Author(s)
Jang, Byoung KukKim, Eun SooPark, Kyung SikCho, Kwang BumChung, Woo JinHwang, Jae Seok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Jourmal of Hepatology
Issued Date
2012
Volume
18
Issue
1
Keyword
Hepatitis CChronicRibavirinAlanine transaminasePeginterferon
Abstract
Background/Aims: The treatment for chronic hepatitis C (CHC) is removal of the virus in order to prevent progression to liver cirrhosis and hepatocellular carcinoma (HCC). Few data have been presented regarding the clinical significance of changes in the alanine aminotransferase (ALT) level in this context. We analyzed the patterns of changes in ALT level and investigated the relationship between the rapid normalization of ALT and sustained virologic response (SVR) after combined treatment with peginterferon and ribavirin. Methods: CHC patients (n=370) were classified into four groups according to the initial ALT level and subsequent changes: (1) initially abnormal ALT level and sustained abnormal ALT level during treatment, (2) initially abnormal ALT level but achievement of ALT normalization, (3) initially normal ALT level and variable ALT abnormality during treatment, and (4) initially normal ALT level and sustained normalization of ALT level during treatment. We subdivided groups 1 and 2 into those with patterns of decreased and normalization of ALT, with or without rapid normalization. We checked the end-treatment response (ETR) and SVR rates in each group and the factors associated with SVR, including patterns of changes in ALT level.
Results: A total of 168 patients completed the therapy (age=54.34±10.64 years [mean±SD], 95 males [56.5%], genotype 1:82 [48.8%]). SVR was achieved in 115 (68.45%) of the completely treated patients. The SVR rate was significantly lower in group 1 than in group 2 (37.8 vs. 81.6%, P<0.001), and significantly higher in the rapid normalization group than in the group without rapid normalization (78.5% vs. 41.2%, P<0.001). Multiple logistic regression analysis revealed that age (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.91-0.98, P=0.005), viral genotype (OR=2.76, 95% CI=1.20-6.38, P=0.017), and initial hepatitis C virus RNA titer (OR=0.28, 95% CI=0.10-0.75, P=0.012) were identified as independent significant predictive factors for SVR. Conclusions: The SVR rate is significantly associated with normalization, and especially rapid normalization of ALT. Rapid normalization of ALT by 4 weeks after treatment might be a useful response factor that is readily available in clinical practice, and especially for genotype 1 patients.
Keimyung Author(s)(Kor)
장병국
김은수
박경식
조광범
정우진
황재석
Publisher
School of Medicine
Citation
Yun Jung Kim et al. (2012). Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients. Korean Jourmal of Hepatology, 18(1), 41–47. doi: 10.3350/kjhep.2012.18.1.41
Type
Article
ISSN
1738-222X
DOI
10.3350/kjhep.2012.18.1.41
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36087
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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