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. 2007 Aug;56(8):1111-6.
doi: 10.1136/gut.2006.106690. Epub 2007 Mar 15.

Rapid and early virological response to chronic hepatitis C treatment with IFN alpha2b or PEG-IFN alpha2b plus ribavirin in HIV/HCV co-infected patients

Christopher Payan  1 , Adeline Pivert, Patrice Morand, Samira Fafi-Kremer, Fabrice Carrat, Stanislas Pol, Patrice Cacoub, Christian Perronne, Françoise Lunel; ANRS HC02 RIBAVIC study team
Affiliations

Rapid and early virological response to chronic hepatitis C treatment with IFN alpha2b or PEG-IFN alpha2b plus ribavirin in HIV/HCV co-infected patients

Christopher Payan et al. Gut. 2007 Aug.

Abstract

Background and aims: An algorithm based on a 2 log(10) 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 alpha2b 3 MU x3/week with pegylated interferon alpha2b 1.5 microg/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 log(10) 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.

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Conflict of interest statement

Competing interests: None.

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