title: Response prediction and treatment tailoring for chronic hepatitis C virus genotype 1 infection.
abstract: We monitored early viral response during the treatment of hepatitis C virus (HCV) infection with the aim of identifying predictors of treatment outcome. We studied 53 patients with genotype 1 infection who received 180 microg/week pegylated interferon alfa-2a and 1,000 or 1,200 mg/day ribavirin depending on body weight and serially assessed HCV RNA in serum, using the Cobas TaqMan assay. Thirty-one patients (58%) achieved sustained viral response (SVR). SVR was obtained in 100% (10/10) of patients with pretreatment viremia concentrations below 400,000 IU/ml, in 100% (14/14) of patients with more than 1.5 log reduction of HCV RNA after 4 days of treatment, and in 95% (22/23) of patients with a rate of decline in viremia higher than 0.70 log units/week during the second phase. Non-SVR was seen in all patients with a second-phase decline rate lower than 0.35 log units/week. Patients with slopes between 0.50 and 0.80 log units/week achieved SVR (4/4) unless the treatment dose was modified (3/3). We conclude that the second-phase slope appears to be an accurate and useful predictor of treatment response. On the basis of these findings, we propose a model of tailored treatment which takes into account the second-phase slope and the amount of HCV RNA after 21 days of treatment.
authors.affiliation: Department of Infection and Virology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden. magnus.lindh@microbio.gu.se
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindh
authors.forename: Erik
authors.initials: E
authors.lastname: Alestig
authors.forename: Birgitta
authors.initials: B
authors.lastname: Arnholm
authors.forename: Anders
authors.initials: A
authors.lastname: Eilard
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Hellstrand
authors.forename: Martin
authors.initials: M
authors.lastname: Lagging
authors.forename: Thomas
authors.initials: T
authors.lastname: Wahlberg
authors.forename: Rune
authors.initials: R
authors.lastname: Wejstål
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.forename: Gunnar
authors.initials: G
authors.lastname: Norkrans
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a