title: Nonimmune complexed HCV RNA titer in serum as a predictor of interferon response in patients with chronic hepatitis C.
abstract: OBJECTIVE
  Hepatitis C virus (HCV) has been reported to exist in the circulation of patients in various forms such as free virions, immune complexes, and nucleocapsids. To clarify the clinical significance of serum HCV titers according to the forms of virus particles, we evaluated the immune complexed (IC) and nonimmune complexed (NIC) HCV RNA titers in 77 chronic hepatitis patients treated with interferon (IFN).
  
  
  METHODS
  IC and NIC forms in pretreatment serum were separated by immunoprecipitation using antihuman immunoglobulin antibody, and quantified by reverse transcription polymerase chain reaction.
  
  
  RESULTS
  Serum titers of NIC HCV RNA were correlated with those of whole serum HCV RNA (r = 0.96, p < 0.01) and IC HCV RNA (r = 0.98, p < 0.01), but they were not with the aminotransferase levels, gamma-globulin concentration, and grading or staging of liver histology. Nonresponders to IFN had significantly high NIC HCV RNA titers compared with sustained responders (10(4.93 +/- 0.81) copies/ml vs 10(4.06 +/- 0.69) copies/ml, p < 0.01). It is noteworthy that the relative amount of NIC HCV RNA to whole serum HCV RNA was also significantly higher in nonresponders than in sustained responders (0.66 +/- 0.10 vs 0.50 +/- 0.11, p < 0.0001). Multivariate analysis showed that low NIC HCV RNA titer (p < 0.01) and genotype 2 (p = 0.02) were independent variables contributing to sustained response to IFN, but the whole serum HCV RNA titer was not.
  
  
  CONCLUSIONS
  Pretreatment NIC HCV RNA titer is a more reliable predictive marker than genotype or whole serum HCV RNA of a sustained response to IFN monotherapy. This finding suggests that humoral immunity may affect the response to IFN.
authors.affiliation: Third Department of Internal Medicine, Mie University School of Medicine, Tsu, Mie, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kaito
authors.forename: Masaki
authors.initials: M
authors.lastname: Takeo
authors.forename: Motoh
authors.initials: M
authors.lastname: Iwasa
authors.forename: Jiro
authors.initials: J
authors.lastname: Ikoma
authors.forename: Shozo
authors.initials: S
authors.lastname: Watanabe
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Adachi
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D012367:RNA, Viral; D007372:Interferons