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AIM:Smoking may affect adversely the response rate tointerferon-α.Our objective was to verify this issue amongchronic hepatitis C patients.METHODS:Over the year 1998,138 chronic hepatitis Cmale Egyptian patients presenting to Cairo Liver Center,were divided on the basis of smoking habit into:group Iwhich comprised 38 smoker patients(>30 cigarettes/d)and group Ⅱ which included 84 non-smoker patients.Irregular and mild smokers(16 patients)were excluded.Non eligible patients for interferon-α therapy were excludedfrom the study and comprised 3/38(normal ALT)in groupI and 22/84 in group Ⅱ(normal ALT,advanced cirrhosisand thrombocytopenia).Group I was randomly allocatedinto 2 sub-groups:group Ia comprised 18 patients whowere subjected to therapeutic phlebotomy while sub-groupIb consisted of 17 patients who had no phlebotomy.Insub-group la,3 patients with normal ALT after repeatedphlebotomies were excluded from the study.Interferon-α2b 3 MU/TIW was given for 6 mo to 15 patients in groupIa,17 patients in group Ib and 62 patients in group Ⅱ.Biochemical,virological end-of-treatment and sustainedresponses were evaluated.RESULTS:At the end of interferon-α treatment,ALT wasnormalized in 3/15 patients(20%)in group Ia and 2/17patients(11.8%)in group Ib compared to17/62 patients(27.4%)in group Ⅱ(P=0.1).Whereas 2/15 patients(13.3%)in group Ia.and 2/17 patients(11.8%)in group Ib lostviraemia compared to 13/62 patients(26%)in group Ⅱ(P=0.3).Six months later,ALT was persistently normalin 2/15 patients(13.3%)in group 1a and 1/17 patients(5.9%)in group Ib compared to 9/62 patients(14.5%)ingroup Ⅱ(P=0.47).Viraemia was eliminated in 1/15 patients(6.7%)in group Ia and 1/17 patients(5.9%)in group Ibcompared to 7/62 patients(11.3%) in group Ⅱ,but theresults did not mount to statistical significance(P=0.4).CONCLUSION:Smokers suffering from chronic hepatitisC tend to have a lower response rate to interferon-α compared to non-smokers.Therapeutic phlebotomy improves theresponse rate to interferon-α therapy among this group.
AIM: Smoking may affect adversely the response rate to interferon-α. Our objective was to verify this issue among chronic hepatitis C patients. METHHODS: Over the year 1998, 138 chronic hepatitis Cmale Egyptian patients presenting to Cairo Liver Center, were divided on the basis of Smoking habit into: group Iwhich comprised 38 smoker patients (> 30 cigarettes / d) and group II which included 84 non-smoker patients. Irregular and mild smokers (16 patients) were excluded. Non eligible patients for interferon-α therapy were excludedfrom the study and comprised 3/38 (normal ALT) in group I and 22/84 in group II (normal ALT, advanced cirrhosis and thrombocytopenia) .Group I was randomly allocatedinto 2 sub-groups: group Ia comprised 18 patients whowere subjected to therapeutic phlebotomy while sub -groupIb consisted of 17 patients who had no phlebotomy.Insub-group la, 3 patients with normal ALT after repeatedphlebotomies were excluded from the study.Interferon-α2b 3 MU / TIW was given for 6 months to 15 patients in grou pIa, 17 patients in group Ib and 62 patients in group II. Biochemical, virological end-of-treatment and sustainedresponses were.P.RESULTS: At the end of interferon-α treatment, ALT was normalized in 3/15 patients (20%) in group Ia and 2/17 patients (11.8%) in group Ib compared to 17/62 patients (27.4%) in group II (P = 0.1) .Whereas 2/15 patients (13.3%) in group Ia.and 2/17 patients 11.8%) in group Ib lostviraemia compared to 13/62 patients (26%) in group II (P = 0.3) .Six months later, ALT was persistently normalin 2/15 patients (13.3%) in group 1a and 1/17 patients (5.9%) in group Ib compared to 9/62 patients (14.5%) ingroup II (P = 0.47). Viraemia was eliminated in 1/15 patients (6.7%) in group Ia and 1/17 patients group Ibcompared to 7/62 patients (11.3%) in group Ⅱ, but the results did not mount to statistical significance (P = 0.4) .CONCLUSION: Smokers suffering from chronic hepatitis C tend to have a lower response rate to interferon-α compared to non -smokers.Therapeutic phlebotomy improves theresponse rate to interferon-α therapy among this group.