Open AccessResponse Prediction and Treatment Tailoring for Chronic Hepatitis C Virus Genotype 1 Infection
Author(s) -
Magnus Lindh,
Erik Alestig,
Birgitta Arnholm,
Anders Eilard,
Kristoffer Hellstrand,
Martin Lagging,
Thomas Wahlberg,
Rune Wejstål,
Johan Westin,
Gunnar Norkrans
Publication year - 2007
Publication title -
journal of clinical microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.349
H-Index - 255
eISSN - 1070-633X
pISSN - 0095-1137
DOI - 10.1128/jcm.00577-07
Subject(s) - viremia , ribavirin , medicine , pegylated interferon , gastroenterology , hepatitis c virus , viral load , taqman , interferon , hepatitis c , hepacivirus , immunology , virus , virology , real time polymerase chain reaction , biology , biochemistry , gene
We monitored early viral response during the treatment of hepatitis C virus (HCV) infection with the aim of identifying predictors of treatment outcome. We studied 53 patients with genotype 1 infection who received 180 μg/week pegylated interferon alfa-2a and 1,000 or 1,200 mg/day ribavirin depending on body weight and serially assessed HCV RNA in serum, using the Cobas TaqMan assay. Thirty-one patients (58%) achieved sustained viral response (SVR). SVR was obtained in 100% (10/10) of patients with pretreatment viremia concentrations below 400,000 IU/ml, in 100% (14/14) of patients with more than 1.5 log reduction of HCV RNA after 4 days of treatment, and in 95% (22/23) of patients with a rate of decline in viremia higher than 0.70 log units/week during the second phase. Non-SVR was seen in all patients with a second-phase decline rate lower than 0.35 log units/week. Patients with slopes between 0.50 and 0.80 log units/week achieved SVR (4/4) unless the treatment dose was modified (3/3). We conclude that the second-phase slope appears to be an accurate and useful predictor of treatment response. On the basis of these findings, we propose a model of tailored treatment which takes into account the second-phase slope and the amount of HCV RNA after 21 days of treatment.