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Viral kinetics during antiviral therapy in patients with chronic hepatitis C and persistently normal ALT levels.

Abstract
The aim of the present study was to compare viral kinetics between patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels and those with elevated ALT levels. Kinetic parameters were derived from nonlinear, least square fitting of serum hepatitis C virus RNA quantifications collected from patients with chronic hepatitis C and persistently normal (n = 20) and elevated (n = 19) ALT levels before and during treatment with 180 mug pegylated interferon alpha-2a once weekly plus daily ribavirin. Patients with chronic hepatitis C and persistently normal ALT levels showed a trend to lower pretreatment infected cell loss (delta) (P = .13) but no differences in efficacy of blocking virus production (epsilon) and infected cell loss during treatment (mdelta) compared with patients with elevated ALT levels. Differences were significant for epsilon (P = .02) and delta (P = .04) when applying updated "healthy" levels for ALT (0.75 times and 0.63 times upper limit of normal for male and female patients, respectively). A significant reduction of the kinetic parameters epsilon, delta, and mdelta was observed in patients with elevated gamma-glutamyltranspeptidase (GGT) levels compared with patients with normal GGT levels (P = .02, P = .005, and P = .02, respectively). In conclusion, viral kinetics are similar in patients with chronic hepatitis C and persistently normal ALT levels and those with elevated ALT levels. However, in patients with elevated GGT levels, a major association with reduced efficacy of blocking virus production and lower infected cell loss was observed. These data show that virological response in patients with chronic hepatitis C is less associated with baseline ALT than with GGT levels.
AuthorsBernd Kronenberger, Eva Herrmann, Florence Micol, Michael von Wagner, Stefan Zeuzem
JournalHepatology (Baltimore, Md.) (Hepatology) Vol. 40 Issue 6 Pg. 1442-9 (Dec 2004) ISSN: 0270-9139 [Print] United States
PMID15565603 (Publication Type: Clinical Trial, Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • peginterferon alfa-2a
  • Polyethylene Glycols
  • Ribavirin
  • interferon alfa-2a
  • gamma-Glutamyltransferase
  • Alanine Transaminase
Topics
  • Adult
  • Aged
  • Alanine Transaminase (blood)
  • Antiviral Agents (administration & dosage)
  • Drug Therapy, Combination
  • Female
  • Hepacivirus (drug effects, growth & development)
  • Hepatitis C, Chronic (blood, drug therapy, virology)
  • Humans
  • Interferon-alpha (administration & dosage)
  • Kinetics
  • Male
  • Middle Aged
  • Polyethylene Glycols (administration & dosage)
  • Recombinant Proteins
  • Ribavirin (administration & dosage)
  • gamma-Glutamyltransferase (blood)

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