title: Patterns of HCV-RNA and HCV core antigen in the early monitoring of standard treatment for chronic hepatitis C.
abstract: BACKGROUND
  An early drop of HCV-RNA levels is useful in assessing response to antiviral treatment in chronic hepatitis C; the first recommended time point is 4 weeks after the start of therapy.
  
  
  OBJECTIVE
  We evaluated retrospectively HCV-RNA and HCVAg levels at different time points to assess the clinical value of an early monitoring.
  
  
  METHODS
  Thirty-five patients with chronic hepatitis C infected by genotype 1b and consecutively enrolled in an open-label study on PegIFN plus Ribavirin and/or ketoprofene were tested for HCV-RNA (real-time PCR) and HCVAg (ARCHITECT) at baseline and after 1 and 2 days and 1, 2, 4 and 12 weeks after the start of treatment. Treatment response was assessed according to the EASL consensus criteria.
  
  
  RESULTS
  In the 17 sustained responders (SR) the median log decrease of HCV-RNA and HCVAg at the different time points was 0.40 and 0.37; 1.36 and 0.84; 1.47 and 0.97; 2.34 and 1.86; 2.51 and 2.32; 3.28 and 2.61, respectively. The best time point to predict SR was 2 weeks after the start of therapy, with a sensitivity, specificity and overall accuracy of 76.9%, 86.7% and 82.1% for HCV-RNA and 81.8%, 75.0% and 76.8% for HCVAg, respectively.
  
  
  CONCLUSIONS
  An early monitoring is at least equally effective than standard monitoring in predicting response to hepatitis C therapy. The similarity of HCV-RNA and HCVAg kinetics suggests that HCVAg may be useful in the early phases as a trigger to evaluate HCV-RNA levels at earlier time points for a personalized approach to therapy monitoring.
authors.affiliation: Department of Clinical Medicine, University of Bologna, Bologna, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Loggi
authors.forename: Carmela
authors.initials: C
authors.lastname: Cursaro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Scuteri
authors.forename: Elena
authors.initials: E
authors.lastname: Grandini
authors.forename: Arianna Martello
authors.initials: AM
authors.lastname: Panno
authors.forename: Silvia
authors.initials: S
authors.lastname: Galli
authors.forename: Giuliano
authors.initials: G
authors.lastname: Furlini
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.forename: Claudio
authors.initials: C
authors.lastname: Galli
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage*; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014758:Viral Core Proteins / Q000097:blood*
chemical_list: D000956:Antigens, Viral; D000998:Antiviral Agents; D012367:RNA, Viral; D014758:Viral Core Proteins; C069130:nucleocapsid protein, Hepatitis C virus