Viral kinetics can predict early response to alpha-interferon in
chronic hepatitis C
Abstract:
Aims/Background:
Response rates to alpha-interferon therapy for chronic hepatitis C
are poor. An early indication of efficacy would reduce the need for
prolonged therapy, leading to significant cost savings. It was
established that a change in quantitative hepatitis C virus RNA
(HCV-RNA) titre at 4 weeks could predict the outcome of
alpha-interferon therapy in chronic hepatitis C.
Methods:
Serum HCV-RNA titres were quantified using branched chain DNA
(bDNA) assay in 26 patients who responded to alpha-interferon
(serum HCV-RNA negative after 12 weeks therapy) and 11 age and sex
matched non-responders. Quantitative bDNA and qualitative RT-PCR
assays for HCV-RNA were measured pretreatment and at 4 weeks. The
change in quantitative HCV-RNA titre between pre-therapy and after
4 weeks was compared in the two groups.
Results:
Seventeen of the 37 patients had become RT-PCR negative at 4 weeks
(early responders) and had an undetectable HCV-RNA titre on bDNA
assay. Nine patients were RT-PCR positive at 4 weeks but negative
by 12 weeks (delayed responders), and of these, 8 had an
undetectable viral titre at 4 weeks on bDNA assay. The patient with
a detectable HCV titre did become RT-PCR negative after 12 weeks,
but subsequently became RT-PCR positive again at 24 weeks. All the
non-responders had a detectable bDNA titre (greater than 0.2
Meq/ml) at 4 weeks.
Conclusions:
Change in quantitative HCV-RNA titre measured by bDNA assay at 4
weeks predicts response to alpha interferon. If HCV-RNA remains
detectable on bDNA assay at 4 weeks, no sustained response to
treatment is found and alpha-interferon can be discontinued.
AUTHOR: Walsh KM, Good T, Cameron S, Thorburn D, McCruden
EAB, Mills PR, Morris AJ
SOURCE: LIVER 18: (3) 191-195 JUN 1998
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