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Predictive value of early HCV RNA quantitation for sustained response in nonresponders receiving daily interferon and ribavirin therapy
Author(s) -
Trimoulet Pascale,
de Lédinghen Victor,
Foucher Juliette,
Castéra Laurent,
Fleury Hervé,
Couzigou Patrice
Publication year - 2004
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/jmv.10528
Subject(s) - ribavirin , medicine , viral load , hepatitis c virus , predictive value , interferon , gastroenterology , alpha interferon , hepatitis c , hepacivirus , receiver operating characteristic , virology , virus , immunology
Abstract The prognostic value of early hepatitis C virus (HCV)‐RNA load was evaluated among nonresponder patients to previous interferon (IFN) therapy treated with daily IFN and ribavirin. One hundred‐six nonresponders (83 men), mean age 44.8 ± 11 years, were treated with IFN‐α2b 3 MU/day for 24 weeks, followed by 3 MU × 3/week for 24 weeks plus ribavirin 1–1.2 g/day for 48 weeks. HCV RNA was quantified by Versant HCV RNA 3.0 assay (Bayer). The predictive values of the baseline and the change in viral load at week 1, 4, and 12 for sustained virological responses were analyzed using receiver operating characteristic (ROC) curves, as well as predictive values of >2 log 10 drop from baseline by weeks 1, 4, and 12 in combination with undetectable HCV RNA for sustained virological response. Thirty‐two patients (30.2%) were sustained virological responders. The highest area under the curve was obtained at week 4. The unquantifiable HCV RNA level, in combination with at least a 2 log 10 drop in viral load by week 4 and week 12, had a negative predictive value of 96% and 97%, respectively. Nonresponse can be predicted as early as week 4 or week 12 in nonresponders treated with daily IFN and ribavirin. J. Med. Virol. 72:46–51, 2004. © 2004 Wiley‐Liss, Inc.