Prediction of relapse after interferon therapy in hepatitis C virus-infected patients by the use of triple assay.
METHODS
In recent years, several tests have been used as predictive factors for relapse after the end of interferon therapy of chronic hepatitis C carriers. Serum hepatitis C virus (HCV)-RNA has proved insensitive for predicting relapse because more than 50% of patients with undetectable reverse transcription-polymerase chain reaction (RT-PCR) levels of HCV at the end of therapy become positive for viral RNA after interferon withdrawal. The detection of a minus RNA strand of HCV in liver also failed to efficiently predict relapses in chronic hepatitis patients. Furthermore, the use of a whole blood assay of HCV-RNA has been controversial. We used a triple assay comprised of RT-PCR tests for the detection of HCV-RNA plus strand in serum and peripheral blood mononuclear cells (PBMC), together with testing for the minus strand in PBMC for prediction of relapse after interferon + ribavirin combination therapy in 45 patients with chronic hepatitis C.


RESULTS
The only four patients with a negative triple assay had no relapse 1 year after the end of therapy. In contrast, two-thirds of the 12 patients who tested negative for viral RNA in serum at the end of therapy relapsed 1 year later.


CONCLUSIONS
We concluded that the absence of both minus and plus strands in patients who tested negative for serum PCR may indicate the total eradication of HCV.
El-Awady
Mostafa K
MK
Departments of Biomedical Technology and Human Genetics, National Research Center, Giza and Tropical Medicine, Al-Azhar University, Cairo, Egypt.
Abdel Rahman
Mohamed M
MM
Ismail
Somayia M
SM
Amr
Khalda S
KS
Omran
Moataza
M
Mohamed
Sabry A
SA
D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005544:Forecasting; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D009000:Monocytes / Q000737:chemistry / Q000821:virology; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014766:Viremia / Q000188:drug therapy
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins