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Rapid and early virological response to chronic Hepatitis C treatment with IFN alpha-2b or PEG- IFN alpha-2b plus ribavirin in HIV/HCV co-infected patients
  1. Christopher Payan (christopher.payan{at}chu-brest.fr)
  1. Laboratoire de Bactériologie-Virologie-Hygiéne Hospitalière, CHU Angers, France
    1. Adeline Pivert (adpivert{at}chu-angers.fr)
    1. Laboratoire de Bactériologie-Virologie-Hygiéne Hospitalière, CHU Angers, France
      1. Patrice Morand (pmorand{at}chu-grenoble.fr)
      1. Laboratoire de Virologie, CHU Grenoble, France
        1. Samira Fafi-Kremer (sfafi{at}chu-grenoble.fr)
        1. Laboratoire de Virologie, CHU Grenoble, France
          1. Fabrice Carrat (carrat{at}u444.jussieu.fr)
          1. Inserm U707, Facultè de Mèdecine St Antoine, Paris, France
            1. Stanislas Pol (stanislas.pol{at}nck.ap-hop-paris.fr)
            1. Service d' Hèpatologie, Hopital Necker-Enfants Malades, Paris, France
              1. Patrice Cacoub (patrice.cacoub{at}psl.ap-hop-paris.fr)
              1. Service de Mèdecine Interne, Hopital Pitiè-Salpètrière, Paris, France
                1. Christian Perronne (c.perronne{at}rpc.ap-hop-paris.fr)
                1. Service des Maladies Infectieuses et Tropicales, Hopital Raymond Poincarè, Paris, France
                  1. Françoise Lunel (frlunel-fabiani{at}chu-angers.fr)
                  1. Laboratoire de Bactériologie-Virologie-Hygiéne Hospitalière, CHU Angers, France

                    Abstract

                    Background and aim: An algorithm based on a 2 log10 decline of HCV RNA at week (W) 12 has been proposed in US and European recommendations for the management of patients with chronic hepatitis C treated with pegylated- interferon and ribavirin.

                    Methods: We have studied rapid virological response (RVR, i.e. at W2 and W4 after the initiation of therapy) in HIV/HCV co-infected patients. Using HCV RNA measurements (Versant® HCV RNA 3.0, Cobas Amplicor HCV 2.0), RVR was studied in 323 patients from the ANRS HC02 RIBAVIC trial, comparing Interferon α2b 3 MU x3/week versus Pegylated Interferon α2b 1.5 μg/kg/week, each combined with ribavirin 800 mg/day during 48 weeks.

                    Results: The best positive and negative predictive values of sustained virological response (SVR) were respectively obtained with an undetectable HCV RNA at W4 (97%) and with more than a 2 log10 decrease at W12 (99%). Prediction of non-SVR was obtained in all patients by using HCV RNA cutoff levels above 460,000 IU/ml at W4 and above 39,000 UI/ml at W12 whatever the HCV genotype and arm of treatment.

                    Conclusion: We propose a new algorithm based on RVR thresholds using HCV RNA that allows for excellent prediction of non-SVR as early as W4.

                    • HCV viral load
                    • HIV/HCV coinfection
                    • hepatitis C therapy
                    • prediction of response
                    • rapid and early viral decline

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