Rapid and early virological response to chronic hepatitis C treatment with IFN α2b or PEG-IFN α2b plus ribavirin in HIV/HCV co-infected patients. Issue 8 (15th March 2007)

• Record Type: Journal Article
• Authors: Payan, Christopher; Pivert, Adeline; Morand, Patrice; Fafi-Kremer, Samira; Carrat, Fabrice; Pol, Stanislas; Cacoub, Patrice; Perronne, Christian; Lunel, Françoise
• Is Part Of: Gut. Volume 56:Issue 8(2007)
• Page Start: 1111
• Page End: 1116
• Publication Date: 2007-03-15
• Subjects: EVR, early virological response -- HAART, highly active antiretroviral treatment -- HCV, hepatitis C virus -- IFN, interferon -- NPV, negative predictive value -- NR, non-responders -- PEG-IFN, pegylated interferon -- PPV, positive predictive value -- RB, responders with breakthrough -- ROC, receiver operating characteristics -- RR, responders with relapse -- RVR, rapid virological response -- SVR, sustained virological response/responders; HIV/HCV co-infection -- hepatitis C therapy -- HCV viral load -- rapid and early viral decline -- prediction of response; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2006.106690
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background and aims: An algorithm based on a 2 log10 decline in hepatitis C virus (HCV) RNA at week (W) 12 has been proposed in US and European recommendations for the management of patients with chronic hepatitis C treated with pegylated-interferon and ribavirin. Methods: We examined rapid virological response (RVR; at W2 and W4 after the initiation of therapy) in HIV/HCV co-infected patients. Using HCV RNA measurements (Versant HCV RNA 3.0, Cobas Amplicor HCV 2.0), RVR was studied in 323 patients from the ANRS HC02 RIBAVIC trial, comparing interferon α2b 3 MU ×3/week with pegylated interferon α2b 1.5 μg/kg/week, each combined with ribavirin 800 mg/day over 48 weeks. Results: The best positive and negative predictive values of sustained virological response (SVR) were obtained with an undetectable HCV RNA at W4 (97%) and with more than a 2 log10 decrease at W12 (99%), respectively. Prediction of non-SVR was obtained in all patients by using HCV RNA cut-off levels above 460 000 IU/ml at W4 and above 39 000 UI/ml at W12 irrespective of the HCV genotype and arm of treatment. Conclusion: We propose a new algorithm based on RVR thresholds using HCV RNA that allows for excellent prediction of non-SVR as early as W4.