EARLY HEPATITIS-C VIRUS-RNA RESPONSES PREDICT INTERFERON TREATMENT OUTCOMES IN CHRONIC HEPATITIS-C

In previous studies employing interferons (IFNs) in the treatment of c hronic hepatitis C, there have been few reliable predictors of sustain ed responses. We retrospectively evaluated the predictive value of hep atitis C virus (HCV)-RNA measurements in the first few months during c onsensus interferon (CIFN) treatment using a sensitive reverse-transcr iptase polymerase chain reaction assay to determine sustained response s. Data from two large treatment trials, one of IFN-naive patients and one of retreated relapsers and nonresponders, were used, including se rum samples at 2-week intervals in the naive study and 8-week interval s in the retreatment study. Patients received initial CIFN (9 mu g) tr eatment for 6 months and were assessed 6 months after treatment. There were 28 sustained viral responders of 232 CIFN-treated patients. Of t he sustained responders, 48% had already cleared HCV RNA from serum (< 100 copies/mL) by week 2, 78% by week 4, 81% by week 6, and 96% by wee k 12. Patients with early HCV-RNA clearance were more likely to have s ustained responses than those who responded later. Early clearance of HCV from serum was also associated with greater likelihood of a sustai ned response to 48 weeks of retreatment with 15 mu g CIFN. Ninety-five percent of the sustained responders were HCV-RNA-negative by week 8 o f retreatment, Early assessment of HCV RNA may help in the prediction of sustained responses to IFN and allow the value of continued treatme nt tea be determined early in the course of IFN therapy.