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Hepatic HCV‐RNA as a predictor of outcome after interferon therapy in patients with chronic hepatitis C
Author(s) -
KONDO MASAAKI,
TANAKA KATSUAKI,
IKEDA MASANORI,
ARATA SHINJU,
SAITO SATORU,
SAKAGUCHI TAKASHI,
MORIMOTO MANABU,
FUJII TAKANDO,
MITSUI KONOMI,
OKAZAKI HIROSHI,
HOSHINO MASATO,
SEKIHARA HISAHIKO
Publication year - 1996
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1996.tb00068.x
Subject(s) - medicine , interferon , gastroenterology , rna , hepatitis c , hepatitis c virus , refractory (planetary science) , antiviral therapy , chronic hepatitis , immunology , virus , biology , gene , biochemistry , astrobiology
Measurement of serum HCV‐RNA is a useful index for evaluating the antiviral effect of interferon therapy in chronic hepatitis C. In the present study, we investigated whether the detection of hepatic HCV‐RNA after interferon treatment, using a polymerase chain reaction assay, predicted long‐term response to therapy in patients with chronic hepatitis C. Thirty‐three patients underwent liver biopsies before and after interferon therapy. Histology and clinical courses were compared after treatment. Before therapy, serum and hepatic HCV‐RNA was detected in specimens from 32 (97%) and 33 (100%) patients, respectively. Serum HCV‐RNA became undetectable in samples from 22 (67%) patients; however, in 10 of these patients (45%), serum HCV‐RNA levels relapsed after therapy. Hepatic HCV‐RNA became undetectable in 14 patients after therapy and the serum aminotransferase concentration remained within normal limits during and following (24–92 weeks) therapy in 12 of these patients (86%). All 11 patients with detectable hepatic HCV‐RNA also had serum HCV‐RNA and elevated aminotransferase concentrations refractory to therapy. The absence of hepatic HCV‐RNA at the end of interferon treatment thus predicted a long‐term complete response to therapy with a sensitivity of 100%, a specificity of 90% and an accuracy of 94%. We conclude that hepatic rather than serum HCV‐RNA is a more useful index for the prediction of the long‐term efficacy of interferon therapy.