title: Role of HCV-RNA decay and IP-10 levels after 48 hours of standard HCV therapy as predictors of rapid virological response.
abstract: OBJECTIVE
  Rapid virological response (RVR) is a critical end-point in the era of the new direct-acting antiviral agents (DAA). The aim of this study was to evaluate the predictive value in achieving RVR of HCV-RNA load and IP10 after 48 hours of standard anti HCV therapy.
  
  
  METHODS
  HCV mono-infected and HIV/HCV co-infected patients naives to interferon were included. Demographic data, immune-virological HIV-related condition and HCV disease status were recorded before starting treatment. HCV-RNA and IP10 concentrations were also measured 48 hours after first interferon dose. Univariate model, logistic regression and ROC curve were performed for statistical analysis.
  
  
  RESULTS
  Thirty-two patients were enrolled (mean age 49.2 ± 5.6 years): all were treated with pegylated-interferon and ribavirin. Nineteen (59.3%) were HIV/HCV co-infected patients. RVR was reached in 10 patients (31.2%). A decline of more than two log of HCV-RNA after 48 hours of therapy was associated with RVR (P=0.004). A trend was observed between increased IP10 levels at 48 hours and RVR (P=0.08). In a multivariable model only HCV-RNA at 48 hours was associated with RVR (P=0.011). ROC curve analysis for both HCV-RNA at 48 hours and IP-10 at 48 hours showed an area under the curve of 0.87 (95%CI: 0.74-1; P=0.001) with specificity of 72.2% and sensibility of 90%.
  
  
  CONCLUSIONS
  In HCV treatment-naïve patients HCV-RNA and IP10 determination after 48 hours of interferon and ribavirin may be a worthwhile endpoint to predict RVR and select patients that may not require DAA addition.
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy. Electronic address: prinapori@alice.it.
authors.forename: Roberta
authors.initials: R
authors.lastname: Prinapori
authors.affiliation: Hygiene Unit, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Sticchi
authors.affiliation: Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Alicino
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Del Puente
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzarello
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Alessandrini
authors.affiliation: Biostatistic Unit, Department of Health Sciences, Genoa, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Signori
authors.affiliation: Hygiene Unit, IRCCS AOU San Martino-IST, Genoa, Italy; Department of Health Sciences, University of Genoa, Genoa, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
authors.affiliation: Hygiene Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Bruzzone
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Viscoli
authors.affiliation: Infectious Disease Clinic, IRCCS Azienda Ospedaliera Universitaria San Martino - IST, 16132 Genova, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Biagio
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D054357:Chemokine CXCL10 / Q000097:blood*; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020871:RNA Stability; D012367:RNA, Viral / Q000097:blood*; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D054357:Chemokine CXCL10; D012367:RNA, Viral; D012254:Ribavirin; D007372:Interferons