title: Utility of early testing for HCV viremia as predictive factor of sustained response during interferon or interferon plus ribavirin treatment.
abstract: OBJECTIVE
  To evaluate the utility of early testing for hepatitis C viremia as a predictor of treatment outcome during interferon or combination therapy.
  
  
  METHODS
  We studied 184 patients with chronic hepatitis C who received interferon and were monitored for HCV RNA. Sixty-two patients received interferon alone for 12 months and 122 patients, who were still HCV RNA positive at 2 months, received an additional 12-month course of interferon and ribavirin combination therapy.
  
  
  RESULTS
  Using this strategy, sustained response occurred in a total of 34 patients (18.5%). Independent variables associated with sustained response were HCV genotype (p=0.06), viral load < or = 5.1 logs/ml (p= 0.005) and negative HCV RNA at 1 month (p<0.0001) in the interferon group, and female sex (p=0.04), genotype (p=0.03), viral load < or = 5.5 logs/ml (p=0.01), normal ALT (p=0.001) and decline in viral load > or = 1.2 logs/ml after 2 months of interferon monotherapy (p<0.001) and negative viremia at 5 months of ribavirin onset (p<0.0001) in the combination therapy group. Persistence of viremia at 1 month of interferon monotherapy and at 5 months of combination therapy were the strongest predictors of non-response (negative predictive value of 100% and 99%, respectively).
  
  
  CONCLUSIONS
  Qualitative assessment of HCV RNA during treatment is the strongest predictor of sustained response during interferon or combination therapy for chronic hepatitis C.
authors.affiliation: Department of Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Castro
authors.forename: J I
authors.initials: JI
authors.lastname: Esteban
authors.forename: S
authors.initials: S
authors.lastname: Sauleda
authors.forename: L
authors.initials: L
authors.lastname: Viladomiu
authors.forename: E A
authors.initials: EA
authors.lastname: Dragon
authors.forename: R
authors.initials: R
authors.lastname: Esteban
authors.forename: J
authors.initials: J
authors.lastname: Guardia
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016903:Drug Monitoring; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014766:Viremia
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons