Rapid and early virological response to chronic hepatitis C treatment with IFN α2b or PEG-IF N α2b plus ribavirin in HIV/HCV co-infected patients

Payan, Christopher; Pivert, Adeline; Morand, Patrice; Fafi-Kremer, Samira; Carrat, Fabrice; Pol, Stanislas; Cacoub, Patrice; Perronne, Christian; Lunel, Francoise
August 2007
Gut;Aug2007, Vol. 56 Issue 8, p1111
Academic Journal
Background and aims: An algorithm based on a 2 log10 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 HCO2 RIBAVIC trial, comparing interferon α2b 3 MU x3/week with pegylated interferon α2b 1.5 μg/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 log10 decrease at W12 (99%), respectively. Prediction of non-SVR was obtained in all patients by using HCV RNA cut-off levels above 460 000 lU/ml at W4 and above 39 000 UI/mI at W 12 irrespective of the HCV genotype and arm of treatment. Conclusion: We propose a new algorithm based on RVR thresholds using HCV RNA that allows for excellent prediction of non-SVR as early as W4.


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