Anti-HCV IgM as predictor of response to interferon therapy in schistosomal patients with chronic hepatitis C
Derbala, M.F.; Amer, A.M.; El Defrawi, I.E.
Indian Journal of Gastroenterology Official Journal of the Indian Society of Gastroenterology 25(1): 44
2006
ISSN/ISBN: 0254-8860 PMID: 16567901 Document Number: 602014
29 patients with chronic hepatitis C (aged 42-58 years; 17 men and 12 women) and 28 matched patients with concomitant hepatitis C and schistosomiasis (15 men and 13 women) were treated with subcutaneous interferon- alpha 2b (Intron A) 3 MU thrice weekly and oral ribavirin (Rebetron) 1200 mg daily for 12 months [Egypt]. Their alanine aminotransferase (ALT) level, anti-HCV IgM and HCV RNA were assessed in serum samples before treatment, at the end of treatment, and 6 months later. The end-of-treatment response (ETR; i.e., normalization of ALT and loss of detectable serum HCV RNA) and sustained response 6 months later in patients with and without schistosomiasis were similar: 37.9 vs. 28.6% (P=0.2) and 24.1 vs. 10.7% (P=0.18), respectively. Pretreatment anti-HCV IgM was detected in 12 (41.3%) patients without schistosomiasis and 16 (57.1%) patients with schistosomiasis. Most pretreatment anti-HCV IgM seropositive patients elicited no ETR, including 10 patients without schistosomiasis and 15 with schistosomiasis. The patients who responded relapsed 6 months later. On the other hand, 10 patients with pretreatment anti-HCV seronegative non-schistosomiasis and 9 schistosomiasis patients had ETR. Sustained response 6 months later was seen in 7 and 3 patients, respectively. Based on the finding that none of the anti-HCV IgM seropositive patients pretreatment could achieve ETR, it can be suggested that anti-HCV IgM when positive may be used as a predictor of poor response to combined interferon and ribavirin therapy irrespective of the presence of concomitant schistosomiasis.