title: The early HCV RNA dynamics in patients with acute hepatitis C treated with pegylated interferon-alpha2b.
abstract: Interferon and pegylated interferon (peg-IFN) are highly effective in patients with acute hepatitis caused by hepatitis C virus (acute hepatitis C, AHC), but the optimal timing of treatment is still under debate. In this open-labelled, uncontrolled trial, 19 patients with AHC, including 12 intravenous drug users (IVDUs), were treated early in the course of the infection with peg-IFN-alpha2b for 12 weeks. Diagnosis was made according to standardized criteria. The HCV RNA decay was analysed during the first 4 weeks of treatment by quantitative branched-DNA and by qualitative RT-PCR. Of the patients, 11 (58%) had genotype 1. Sustained virological response (SVR) was achieved in 14 out of 19 patients (74%) and the mean time to achieve a negative RT-PCR for HCV RNA was 2.5 weeks. The SVR was associated by univariate analysis with peg-IFN dosage < or = 1.33 microg/kg/week (P = 0.026) and HCV RNA level at onset of therapy (P = 0.017). Using a logistic regression model, only peg-IFN dosage > or = 1.33 microg/kg/weekly was significantly associated with SVR (P = 0.0379, OR: 14.7; 95% CI: 1.16-185.2). The SVR was 100% and 83.3%, respectively, in genotype 1 and non-1 infected patients treated with a dosage equal to or higher than 1.33 microg/kg, compared with 40% and 50%, respectively, in those who received a lower dosage. Efforts should be made to propose a 12-week treatment with peg-IFN-alpha2b for AHC, and to maximize peg-IFN dosage. Early treatment is associated with early disappearance of HCV RNA.
authors.affiliation: Clinica Malattie Infettive, Università di Torino, Turin, Italy. francescogiuseppe.derosa@unito.it
authors.forename: Francesco G
authors.initials: FG
authors.lastname: De Rosa
authors.forename: Olivia
authors.initials: O
authors.lastname: Bargiacchi
authors.forename: Sabrina
authors.initials: S
authors.lastname: Audagnotto
authors.forename: Silvia
authors.initials: S
authors.lastname: Garazzino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cariti
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Veronese
authors.forename: Riccardo
authors.initials: R
authors.lastname: Raiteri
authors.forename: Guido
authors.initials: G
authors.lastname: Calleri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Perri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics* / Q000378:metabolism; D006526:Hepatitis C / 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 / Q000097:blood* / Q000378:metabolism; D011994:Recombinant Proteins
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b