Optimal follow-up time to determine the sustained virological response in patients with chronic hepatitis C receiving Peg-IFN and ribavirin

Journal of Gastroenterology and Hepatology, 06/09/2011

The assessment of serum HCV–RNA FW + 12, using the highly sensitive real–time PCR assay, is almost as effective as FW + 24 to predict sustained virological response (SVR). There are false negatives in female patients with a high viral load of genotype Ib when the SVR is predicted by FW + 12. The current standard with FW + 24 is reasonable, but the assessment of serum HCV–RNA FW + 12 may be effective in most patients.

Methods

  • 222 patients with chronic hepatitis C were included in this study.
  • Pegylated interferon (Peg–IFN) and ribavirin were administered for 24–72 weeks based on the genotype and viral load.
  • Serum HCV–RNA was measured using real–time PCR at pretreatment, the end of treatment, FW + 4, FW + 8, FW + 12, FW + 16, FW+20 and FW+24.

Results

  • 200 patients had a virological response at the end of treatment.
  • 148 of 200 (74.0%) patients with a virological response at the end of treatment had an SVR at the FW + 24.
  • The positive predictive value (PPV) to identify patients with SVR at FW + 4, FW + 8, FW + 12 was 87.1, 96.1, 98.0%, respectively.
  • The viral load showed a reversion to the basal level as early as 8 weeks in relapse patients.
  • There were only 3 patients who relapsed after FW + 12 and all 3 of these patients were females with genotype Ib and a high viral load.

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