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, 06/09/2011Namikawa M et al.
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.
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.
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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