title: Early hepatitis C virus changes and sustained response in patients with chronic hepatitis C treated with peginterferon alpha-2b and ribavirin.
abstract: BACKGROUND
  Interferon-based therapy induces changes in viral dynamics in chronic hepatitis C (CHC) patients.
  
  
  OBJECTIVE
  The aim of this study was to assess early hepatitis C virus (HCV)-RNA changes and evaluate its predictive value to achieve sustained viral response (SVR) in patients with CHC treated with peginterferon alpha-2b weekly plus ribavirin daily for 48 weeks.
  
  
  METHODS
  HCV-RNA was measured at baseline, 48 h, 4, 12, 24 and 48 weeks of treatment and 24 weeks after treatment.
  
  
  RESULTS
  Eighteen HCV genotype 1 patients were included (13 male, five female) with a mean age of 44.4+/-11.9 years. Nine patients achieved SVR (50%). Viral decline occurred as early as 48 h; the magnitude of decline was statistically different between both groups (P<0.01). Responders had a > or =1 log(10) drop in HCV-RNA at 48 h (positive predictive value (PPV) of 89% to achieve SVR) that persisted at week 4. By week 12, serum HCV-RNA was undetectable (PPV 100%).
  
  
  CONCLUSIONS
  Our data indicate that peginterferon alpha-2b plus ribavirin treatment produces significant changes in HCV dynamics that can be detected as early as 48 h after the first dose of peginterferon alpha-2b and that these changes are useful in predicting response to therapy in CHC patients.
authors.affiliation: Departments of Gastroenterology and Infectology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14000 Mexico City, Mexico.
authors.forename: J F
authors.initials: JF
authors.lastname: Gallegos-Orozco
authors.forename: A
authors.initials: A
authors.lastname: Loaeza-del Castillo
authors.forename: A P
authors.initials: AP
authors.lastname: Fuentes
authors.forename: M
authors.initials: M
authors.lastname: García-Sandoval
authors.forename: L
authors.initials: L
authors.lastname: Soto
authors.forename: R
authors.initials: R
authors.lastname: Rodríguez
authors.forename: M C
authors.initials: MC
authors.lastname: Gutiérrez-Ruíz
authors.forename: G
authors.initials: G
authors.lastname: Gutiérrez-Reyes
authors.forename: A
authors.initials: A
authors.lastname: Bonder
authors.forename: M A
authors.initials: MA
authors.lastname: Olivera
authors.forename: D
authors.initials: D
authors.lastname: Kershenobich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D012367:RNA, Viral / Q000187:drug effects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy / Q000821:virology
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000410:Alanine Transaminase; C417083:peginterferon alfa-2b