Vnitr Lek 2006, 52(2):153-159

The meaning of viral kinetics in the beginning of the pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C

P. Husa^1,*, P. Šlesinger¹, H. Štroblová², A. Svobodník³

¹ Klinika infekčních chorob Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Petr Husa, CSc.

² Oddělení klinické mikrobiologie FN Brno, pracoviště Bohunice, přednostka prim. MUDr. Alena Ševčíková

³ Centrum biostatistiky a analýz MU Brno, vedoucí doc. RNDr. Ladislav Dušek, Ph.D.

Pegylated interferon α (PEG-IFN) and ribavirin combination therapy is the contemporary standard therapy of the patients chronically infected with hepatitis C virus (HCV).


Objective of the study:
The study is monitoring the changes in viremy through the changes of HCV RNA in serum before and during antiviral therapy and it attempts to find a relationship between the viral kinetics in the beginning of the therapy and the sustained virologic response.


Set of the patients and the methodics:
The study involved 133 patients with chronic infection with HCV, of the average age of 38 years (ranged 18-68 years). 86 of them were men. There were 88 patients who had not been treated before (naive patients), 19 of them were relabing and 26 were non-responders to the previous therapy with conventional IFNα and ribavirin. 106 patients (80 %) were infected with genotype (G) 1, 3 (2 %) with G2, 18 (14 %) with G3, 1 patient with G4 and 1 with G6 (under 1 %), in 4 (3 %) the genotype could not be determined. All of them were treated with the combination of PEG-IFNα-2a (180 μg once a week) and ribavirin (800 mg per day in the infection with G2 or G3, 1 000 mg at the infection with G1 and the weight up to 74 kg, 1 200 mg per day at the infection with G1 and the weight 75 kg and higher).

Results:
Up to now, 122 patients completed the therapy and 93 of them (76 %) had negative HCV RNA in serum at the time of completion of the therapy. Negative HCV RNA after 24 weeks (sustained virologic response † SVR) after the completion of the therapy had 64/107 (60 %) of the treated patients. In the course of 12 weeks of the therapy the viremy decreased by at least 2 decadic logarithms (early virologic response - EVR) in 87 patients (82 %) and in 63 of them (72 %) also SVR was noted. Only 19 patients had not EVR and just 1 one of them, nevertheless, achieved SVR (5 %).

Conclusion:
The achievement of EVR is a prerequisite to the successful therapy for chronic infection with HCV with the combination of PEG-IFNα and ribavirin. Quantitative determination of HCV RNA in serum before and during antiviral therapy is a prerequisite to the modern antiviral therapy for chronic infection with HCV.

Keywords: chronic hepatitis C; viral kinetics; pegylated interferon; ribavirin; sustained viral response

Received: November 9, 2005; Accepted: December 6, 2005; Published: February 1, 2006  Show citation