EARLY LOSS OF SERUM HEPATITIS-C VIRUS-RNA CAN PREDICT A SUSTAINED RESPONSE TO INTERFERON THERAPY IN PATIENTS WITH CHRONIC HEPATITIS-C

Objectives: We evaluated whether the loss of serum hepatitis C virus ( HCV) RNA early in interferon (IFN) therapy would indicate a subsequent response to IFN therapy. Methods: One hundred fourteen patients with chronic hepatitis C were treated with IFN-alpha for 24 weeks. All pati ents were positive for anti-HCV antibodies and serum HCV RNA. Serum HC V RNA was measured by highly sensitive and specific RT-PCR (modified A mplicor HCV). Results: Of 114 patients who were treated with IFN-alpha for 24 weeks, 22 of 29 patients (75.9%) who lost HCV RNA at the first week of treatment, 5 of 14 patients (35.7%) who lost HCV RNA at the s econd week, and 2 of 16 patients (12.5%) who lost HCV RNA at fourth we ek were judged as sustained responder (SR). The SR rate was significan tly higher in patients who lost HCV RNA at the first week of therapy ( p < 0.05). On the contrary, none of 55 patients who retained HCV RNA d uring the first 4 weeks of IFN therapy were judged as SR. Concerning t he patients who lost HCV RNA at the first week of therapy, there were no significant differences in the SR rate in either HCV genotype (1b, 29, and 2b). Conclusions: Our study confirms that the early response t o IFN (loss of HCV RNA at the end of the first week of IFN therapy) ca n be a predictor of the subsequent sustained response to IFN therapy. Additionally, positivity of HCV RNA at the fourth week of IFN therapy can be a predictor of the subsequent nonsustained response to IFN ther apy.