title: Rate and predictors of serum HCV-RNA >6 million IU/mL in patients with chronic hepatitis C.
abstract: BACKGROUND
  Baseline serum HCV-RNA predicts sustained virological response in chronic hepatitis C patients treated with antiviral therapy. A threshold at 6 million IU/mL has been proposed to best discriminate treatment outcomes on sofosbuvir-based regimens. In comparison with the general population, immunosuppressed individuals exhibit greater viral load values.
  
  
  OBJECTIVE
  To estimate the rate and predictors of serum HCV-RNA above 6 millionIU/mL in chronic hepatitis C patients on care outside clinical trials.
  
  
  METHODS
  Serum HCV-RNA values recorded from all chronic hepatitis C patients consecutively attended at our clinic during the last decade were analyzed. Testing had been performed using the COBAS TaqMan HCV test v2.0.
  
  
  RESULTS
  A total of 816 individuals with detectable serum HCV-RNA were identified. The main characteristics of this population were as follows: mean age 48.6 years-old; 73.4% males; mean ALT 82.6IU/L; mean HCV-RNA 6.02logIU/mL; 80.6% HCV genotypes 1 or 4; 34.9% advanced liver fibrosis; 35.4% IL28B-CC alleles. HIV coinfection in 78.7%, of whom 91% were on antiretroviral therapy. Overall, 127 (15.6%) had serum HCV-RNA values >6 millionIU/mL. This high viremia was found in 18.2% of HIV-positive versus 5.7% of HIV-negative subjects (p<0.001). In multivariate analysis, serum HCV-RNA >6 millionIU/mL was only significantly associated with HIV coinfection (OR: 4.03; 95% CI: 1.98-8.19, p<0.01) and HCV genotypes 1 or 4 (OR: 1.88; 95% CI: 1.05-3.37, p=0.03).
  
  
  CONCLUSIONS
  Serum HCV-RNA >6 millionIU/mL is roughly seen in 6% of chronic hepatitis C monoinfected patients, and increases up to 18% in HIV coinfection.
authors: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
authors: Pablo
authors: P
authors: Barreiro
authors: Department of Internal Medicine, La Luz Clinic, Madrid, Spain.
authors: Pablo
authors: P
authors: Labarga
authors: Departament of Infectious Diseases, University Hospital Crosshouse, Kilmarnock, Scotland, United Kingdom.
authors: José V
authors: JV
authors: Fernandez-Montero
authors: Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors: Carmen de
authors: Cd
authors: Mendoza
authors: Puerta de Hierro Research Institute & University Hospital, Majadahonda, Spain.
authors: Laura
authors: L
authors: Benítez-Gutiérrez
authors: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain.
authors: José M
authors: JM
authors: Peña
authors: Infectious Diseases Unit, La Paz University Hospital, Madrid, Spain. Electronic address: vsoriano@dragonet.es.
authors: Vicente
authors: V
authors: Soriano
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral
keywords: Direct-acting antivirals; HIV; Hepatitis C; Sofosbuvir; Viral load