Percentage of Hepatitis C Virus-Infected Hepatocytes Is a Better Predictor of Response Than Serum Viremia Levels

Pegylated α-interferon plus ribavirin is the current therapy for chronic hepatitis C virus (HCV) infection. Serum HCV-RNA concentration before treatment has been identified as an independent predictive factor of response. We have compared the percentage of HCV-infected hepatocytes with the concentration of serum HCV-RNA in baseline samples as predictors of response. We included 97 patients with chronic HCV infection (genotype 1), treated with pegylated-interferon-α2b plus ribavirin. Of these 97, 38 (39%) were sustained responders and 59 (61%) were not. Statistical differences between responders and nonresponders were found regarding the percentage of infected hepatocytes (6.83 ± 4.50% versus 13.44 ± 10.05%; P = 0.00003) but not in serum HCV-RNA concentration [1.71 ± 2.70 (×106 IU/L) versus 1.32 ± 1.86 (×106 IU/L); P = 0.40694]. Other factors associated with response were age, γ-glutamyl transpeptidase level, and absence of previous therapy. Logistic regression demonstrated that percentage of infected hepatocytes (odds ratio, 1.160; 95% confidence interval, 1.065-1.264) and previous therapy (odds ratio, 0.294; 95% confidence interval, 0.109-0.795) were significant predictive factors for response. Therefore, the percentage of infected hepatocytes in liver biopsy before treatment is a better predictive factor of sustained response to 48 weeks of therapy with pegylated α-interferon plus ribavirin than serum HCV-RNA concentration in baseline serum sample.