PT - JOURNAL ARTICLE AU - Christopher Payan AU - Adeline Pivert AU - Patrice Morand AU - Samira Fafi-Kremer AU - Fabrice Carrat AU - Stanislas Pol AU - Patrice Cacoub AU - Christian Perronne AU - Françoise Lunel AU - the ANRS HC02 RIBAVIC study team TI - Rapid and early virological response to chronic hepatitis C treatment with IFN α2b or PEG-IFN α2b plus ribavirin in HIV/HCV co-infected patients AID - 10.1136/gut.2006.106690 DP - 2007 Aug 01 TA - Gut PG - 1111--1116 VI - 56 IP - 8 4099 - http://gut.bmj.com/content/56/8/1111.short 4100 - http://gut.bmj.com/content/56/8/1111.full SO - Gut2007 Aug 01; 56 AB - Background and aims: An algorithm based on a 2 log10 decline in hepatitis C virus (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 examined rapid virological response (RVR; 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 ×3/week with pegylated interferon α2b 1.5 μg/kg/week, each combined with ribavirin 800 mg/day over 48 weeks. Results: The best positive and negative predictive values of sustained virological response (SVR) were obtained with an undetectable HCV RNA at W4 (97%) and with more than a 2 log10 decrease at W12 (99%), respectively. Prediction of non-SVR was obtained in all patients by using HCV RNA cut-off levels above 460 000 IU/ml at W4 and above 39 000 UI/ml at W12 irrespective of 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.