title: Predictors of hepatitis C virus RNA levels in a prospective cohort study of drug users.
abstract: High levels of hepatitis C virus (HCV) RNA are associated with a poor response to treatment of chronic hepatitis C, and a substantial reduction in HCV RNA levels predicts a favorable treatment response. We prospectively studied time-dependent and time-independent predictors of HCV RNA levels in 264 drug users with chronic HCV infection. Interviews on medical history and high-risk behaviors, phlebotomy for HIV viral load, serum HCV RNA levels as measured by the COBAS Amplicor HCV Monitor (Roche Diagnostics, Branchburg, NJ), and a lymphocyte subset assay were performed. Factors associated with HCV RNA levels over time were analyzed using a linear mixed model. Nearly 70% of the participants were men, two thirds were Hispanic, and the mean age was 46 years. HCV RNA levels increased over time. Older age (P < 0.001), HIV seropositivity (P = 0.03), and HCV nongenotype 1 (P = 0.05) were predictors of higher HCV RNA levels on multivariate analysis. Among 142 HIV-seropositive participants, a detectable HIV-1 viral load (P < 0.001) and recent alcohol use (P = 0.02) were predictors of higher HCV RNA levels. The predictors of higher HCV RNA levels found in this longitudinal study are consistent with those of prior cross-sectional studies. Further studies are warranted to determine if treatment of alcohol use affects HCV RNA levels.
authors.affiliation: Department of Medicine, Mount Sinai School of Medicine, New, York, NY 10029, USA. dawn.fishbein@mssm.edu
authors.forename: Dawn A
authors.initials: DA
authors.lastname: Fishbein
authors.forename: Yungtai
authors.initials: Y
authors.lastname: Lo
authors.forename: Dale
authors.initials: D
authors.lastname: Netski
authors.forename: David L
authors.initials: DL
authors.lastname: Thomas
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D015331:Cohort Studies; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D006679:HIV Seropositivity; D016174:Hepacivirus / Q000235:genetics / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000821:virology*; D006801:Humans; D007407:Interviews as Topic; D016131:Lymphocyte Subsets; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013997:Time Factors; D019562:Viral Load
chemical_list: D012367:RNA, Viral