title: Early prediction of nonresponders to treatment with interferon alpha-2b and ribavirin in patients with chronic hepatitis C.
abstract: BACKGROUND
  Treatment of chronic hepatitis C virus (HCV) infection with interferon alpha-2b and ribavirin is costly in terms of side effects, medical resources and drug costs. Furthermore, less than 50% of patients overall have a sustained virological response (SVR).
  
  
  OBJECTIVE
  To determine if the log fall in HCV RNA between baseline and week 1 (b-wk1) and between baseline and week 4 (b-wk4) after starting treatment could identify the nonresponders.
  
  
  METHODS
  Sixty-three patients who had completed a full course of therapy were identified. Quantitative measurements of HCV RNA were analyzed from stored sera, collected prospectively.
  
  
  RESULTS
  SVR was achieved in 47.1% and 47.3% of patients in the b-wk1 and b-wk4 groups, respectively. No patients had an SVR with a fall in HCV RNA of less than 0.35 log10 and 1.05 log10 at week 1 and week 4, respectively. This accounted for 44.4% and 51.7% of the nonresponders in the b-wk1 and b-wk4 groups, respectively. Once the decline in viral load was known, genotype, age, sex and baseline viral load did not provide additional power in predicting treatment responses.
  
  
  CONCLUSIONS
  A fall of 1.05 log10 in HCV RNA at week 4 predicts those patients who will not respond, identifying one-half of all nonresponders; this allows therapy to be stopped early, without depriving any patient who would have an SVR from treatment.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario.
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Liu
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
authors.forename: Tony
authors.initials: T
authors.lastname: Mazzulli
authors.forename: Alison
authors.initials: A
authors.lastname: Murray
authors.forename: Jenny
authors.initials: J
authors.lastname: Heathcote
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*; D013997:Time Factors; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin