title: Rapid and early virological response to chronic hepatitis C treatment with IFN alpha2b or PEG-IFN alpha2b plus ribavirin in HIV/HCV co-infected patients.
abstract: OBJECTIVE
  An algorithm based on a 2 log(10) decline in hepatitis C virus (HCV) RNA at week (W) 12 has been proposed in US and European recommendations for the management of patients with chronic hepatitis C treated with pegylated-interferon and ribavirin.
  
  
  METHODS
  We examined rapid virological response (RVR; at W2 and W4 after the initiation of therapy) in HIV/HCV co-infected patients. Using HCV RNA measurements (Versant HCV RNA 3.0, Cobas Amplicor HCV 2.0), RVR was studied in 323 patients from the ANRS HC02 RIBAVIC trial, comparing interferon alpha2b 3 MU x3/week with pegylated interferon alpha2b 1.5 microg/kg/week, each combined with ribavirin 800 mg/day over 48 weeks.
  
  
  RESULTS
  The best positive and negative predictive values of sustained virological response (SVR) were obtained with an undetectable HCV RNA at W4 (97%) and with more than a 2 log(10) decrease at W12 (99%), respectively. Prediction of non-SVR was obtained in all patients by using HCV RNA cut-off levels above 460,000 IU/ml at W4 and above 39,000 UI/ml at W12 irrespective of the HCV genotype and arm of treatment.
  
  
  CONCLUSIONS
  We propose a new algorithm based on RVR thresholds using HCV RNA that allows for excellent prediction of non-SVR as early as W4.
authors.affiliation: Départment de Microbiologie-EA3882, CHU-Hôpital Morvan, Brest, France.
authors.forename: Christopher
authors.initials: C
authors.lastname: Payan
authors.forename: Adeline
authors.initials: A
authors.lastname: Pivert
authors.forename: Patrice
authors.initials: P
authors.lastname: Morand
authors.forename: Samira
authors.initials: S
authors.lastname: Fafi-Kremer
authors.forename: Fabrice
authors.initials: F
authors.lastname: Carrat
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Christian
authors.initials: C
authors.lastname: Perronne
authors.forename: Françoise
authors.initials: F
authors.lastname: Lunel
mesh_terms: D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D011092:Polyethylene Glycols; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis; D012372:ROC Curve; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b