Plasma HCV-RNA decline in the first 48 h identifies hepatitis C virus mono-infected but not HCV/HIV-coinfected patients with an undetectable HCV viral load at week 4 of peginterferon-alfa-2a/ribavirin therapy |
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Authors: | J E Arends J Cohen Stuart L C Baak M E van der Ende K J van Erpecum C P M Simons G J Boland D van Baarle A I M Hoepelman |
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Institution: | Departments of Internal Medicine and Infectious Diseases;, Medical Microbiology;, Gastroenterology;, Immunology, University Medical Center Utrecht, Utrecht, The Netherlands;;Department of Gastroenterology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands;;and Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Rotterdam, The Netherlands |
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Abstract: | Summary. During peginterferon-alfa-2a/ribavirin therapy, plasma hepatitis C virus (HCV)-RNA decreases with a rapid first phase and a slower second phase. We compared the viral load decrease and slope in the first 48 h in patients with a rapid viral response (RVR, i.e. HCV-RNA < 50 IU/mL at week 4) with patients not achieving an RVR. From 23 HCV-infected (14 mono-infected and nine HCV/HIV-coinfected) genotype 1 or 4 positive peginterferon-alfa-2a/ribavirin-treated patients, plasma HCV-RNA was determined at baseline, 48 h, weeks 1, 2, 4, 8, 12, 48 and 72. The HCV viral load decrease (Δ0–48), the slope (λ1) and the efficiency factor (ε) were determined in the first 48 h after the start of therapy. Five (36%) HCV mono-infected patients and three (33%) HIV/HCV-coinfected patients achieved an RVR whereas six (43%) HCV mono-infected patients and five (56%) HIV/HCV-coinfected patients reached a sustained viral response (SVR). In contrast to HIV/HCV-coinfected patients, five HCV mono-infected patients with an RVR showed both a larger Δ0–48 and steeper λ1 (?1.77log10 IU/mL ± 0.66 and ?2.04/day ± 0.76) compared to nine non-RVR patients (?0.66log10 IU/mL ± 0.39; P = 0.019 and ?0.76/day ± 0.41; P = 0.019). When divided by SVR, a greater Δ0–48 and steeper λ1 were also seen in both HCV mono-infected and HIV/HCV-coinfected patients. Thus, in the first 48 h after the start of therapy, HCV mono-infected patients with an RVR have a larger viral load decrease, steeper viral slope and a higher efficiency factor as compared with non-RVR patients. |
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Keywords: | 48 h first phase genotype 1 and 4 hepatitis C HIV rapid viral response |
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