How soon can a virological sustained response be determined after withdrawal of interferon therapy in chronic hepatitis C?

Hepatitis C virus (HCV)-RNA status and alanine aminotransferase (ALT) level s determined shortly after interferon (IFN) therapy in patients with chroni c hepatitis C do not predict longterm response. To determine the virologica l sustained response after the completion of IFN therapy, HCV-RNA was measu red at the end of treatment and at 3-4 months and 12 months after the compl etion of therapy in 537 patients with chronic hepatitis C. In 347 patients, HCV-RNA was not detected by polymerase chain reaction (PCR) at the complet ion of therapy and 175 of these patients (50%) were still PCR negative 12 m onths later. In contrast, of the 180 patients who were HCV-RNA negative at 3-4 months after completion of therapy, 99% remained negative at 12 months. Normal ALT levels were found in 80, 93 and 95% of patients who were negati ve for HCV-RNA either at the end of treatment or at 3-4 months and 12 month s after the completion of therapy, respectively. Of patients who were HCV-R NA positive, 30, 15 and 20% were found to have normal ALT levels at the sam e respective time points. To determine a sustained virological response sho rtly after the completion of therapy, serum HCV-RNA was serially examined i n 66 patients negative for HCV-RNA at the end of therapy. Of 31 patients wh o relapsed, HCV-RNA reappeared in 33, 80, 97 and 100% of patients by 1, 2, 4 and 8 weeks after the completion of therapy. In conclusion, a sustained v irological response could be determined with 97 and 99% certainty at 4 week s and at 3-4 months after the completion of therapy, respectively.