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Ultracentrifugation and concentration of a large volume of serum for HCV RNA during treatment may predict sustained and relapse response in chronic HCV infection
Author(s) -
McHutchison J.G.,
Blatt L.M.,
Ponnudurai R.,
Goodarzi K.,
Russell J.,
Conrad A.
Publication year - 1999
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/(sici)1096-9071(199904)57:4<351::aid-jmv4>3.0.co;2-v
Subject(s) - medicine , predictive value , ultracentrifuge , liter , virus , gastroenterology , virology , antiviral therapy , viral load , hepatitis c virus , polymerase chain reaction , immunology , chronic hepatitis , biology , chemistry , chromatography , biochemistry , gene
The ability to predict accurately a sustained response during therapy in patients with hepatitis C virus (HCV) infection is unavailable. The aim of this study was to differentiate, during therapy, patients who would relapse from those with a sustained response by ultracentrifugation for residual serum HCV RNA. Sixty‐one specimens (from 32 patients) collected during interferon therapy were assessed by ultracentrifugation. All were negative using a quantitative polymerase chain reaction (PCR) (detection limit ≤ 100 copies/ml). One‐milliliter aliquots were ultracentrifuged at 23,000 × g (160 min), and then the nucleic acid pellet was extracted, precipitated, and resuspended. Qualitative PCR was carried out in quadruplicate using two separate 5′UTR primer sets (8 results/specimen). A specimen was positive if ≥ 1 gels was positive compared to controls. At weeks 12 and 24, 9/9 (100%) sustained response patients were negative by ultracentrifugation. In the 23 relapse patients at week 12, 7/12 specimens were positive; at week 24, 7/14 were positive. Earlier time points could not differentiate the patients' eventual response to therapy. The predictive value of a positive ultracentrifugation test for relapse at week 12 or 24 was 100%. The predictive value of a negative test for sustained response was 62% and 50% at week 12 and 24, respectively. These preliminary results indicate that patients with an eventual sustained response will have no detectable serum HCV RNA by week 12 or week 24. A positive result is 100% predictive of relapse. J. Med. Virol. 57:351–355, 1999. © 1999 Wiley‐Liss, Inc.