TY - JOUR
T1 - Kinetics of the hepatitis C virus during interferon therapy as a marker of therapeutic response
AU - Nakamuta, Makoto
AU - Fukutomi, Takayoshi
AU - Shimohashi, Naoya
AU - Kinukawa, Naoko
AU - Uchimura, Koutaro
AU - Tada, Seiya
AU - Motomura, Kenta
AU - Enjoji, Munechika
AU - Kato, Masaki
AU - Iwamoto, Hiroaki
AU - Tanabe, Yuichi
AU - Imari, Yasuhisa
AU - Sakamoto, Shigeru
AU - Sakai, Hironori
AU - Nawata, Hajime
PY - 2001
Y1 - 2001
N2 - Background: The viral load and subtype of hepatitis C virus (HCV) are predictors of the efficacy of interferon (IFN) therapy. The kinetics of HCV during IFN therapy have been described recently, suggesting that HCV infection is highly dynamic. These observations have raised the issue as to whether early monitoring of the viral load can help guide IFN therapy. Methods: We measured HCV-RNA levels at 0, 24 and 48 h after the start of IFN-α treatment (10 MU daily for 2 weeks and then three times weekly for 22 weeks) or IFN-β treatment (6 MU daily for 6 weeks). Then we analyzed the relationship between HCV kinetics and therapeutic response using stepwise multivariate logistic regression analysis. Results: The exponential decay slope of the viral load during the first 24 h, not the first 48 h or the next 24 h, was a predictor of viral eradication at 6 months after completion of the treatment (sustained response; P = 0.0023). This decay slope was not affected by the HCV serotype or the type of IFN used. Initial viral load and HCV serotype were also predictors, as reported previously (P < 0.0001 and P = 0.0347, respectively). We also proposed a model using a prognostic index that predicted a sustained response with more than 80% sensitivity, specificity and efficacy in an independent and external group of patients. Conclusion: This study demonstrated that the exponential decay slope of the viral load during the first 24 h was an important predictor of the response to IFN therapy as well as the initial viral load and HCV serotype. The model may also be useful for the clinical management of IFN therapy.
AB - Background: The viral load and subtype of hepatitis C virus (HCV) are predictors of the efficacy of interferon (IFN) therapy. The kinetics of HCV during IFN therapy have been described recently, suggesting that HCV infection is highly dynamic. These observations have raised the issue as to whether early monitoring of the viral load can help guide IFN therapy. Methods: We measured HCV-RNA levels at 0, 24 and 48 h after the start of IFN-α treatment (10 MU daily for 2 weeks and then three times weekly for 22 weeks) or IFN-β treatment (6 MU daily for 6 weeks). Then we analyzed the relationship between HCV kinetics and therapeutic response using stepwise multivariate logistic regression analysis. Results: The exponential decay slope of the viral load during the first 24 h, not the first 48 h or the next 24 h, was a predictor of viral eradication at 6 months after completion of the treatment (sustained response; P = 0.0023). This decay slope was not affected by the HCV serotype or the type of IFN used. Initial viral load and HCV serotype were also predictors, as reported previously (P < 0.0001 and P = 0.0347, respectively). We also proposed a model using a prognostic index that predicted a sustained response with more than 80% sensitivity, specificity and efficacy in an independent and external group of patients. Conclusion: This study demonstrated that the exponential decay slope of the viral load during the first 24 h was an important predictor of the response to IFN therapy as well as the initial viral load and HCV serotype. The model may also be useful for the clinical management of IFN therapy.
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U2 - 10.1046/j.1440-1746.2001.02390.x
DO - 10.1046/j.1440-1746.2001.02390.x
M3 - Article
C2 - 11206312
AN - SCOPUS:0035143805
VL - 16
SP - 29
EP - 33
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
SN - 0815-9319
IS - 1
ER -