Early hepatitis C virus changes and sustained response in patients with chronic hepatitis C treated with peginterferon α-2b and ribavirin

Background: Interferon-based therapy induces changes in viral dynamics in chronic hepatitis C (CHC) patients. Aims: The aim of this study was to assess early hepatitis C virus (HCV)-RNA changes and evaluate its predictive value to achieve sustained viral response (SVR) in patients with CHC treated with peginterferon α-2b weekly plus ribavirin daily for 48 weeks. Methods: HCV-RNA was measured at baseline, 48 h, 4, 12, 24 and 48 weeks of treatment and 24 weeks after treatment. Results: Eighteen HCV genotype 1 patients were included (13 male, five female) with a mean age of 44.4 ± 11.9 years. Nine patients achieved SVR (50%). Viral decline occurred as early as 48 h; the magnitude of decline was statistically different between both groups (P <0.01). Responders had a ≥ 1 log₁₀ drop in HCV-RNA at 48 h (positive predictive value (PPV) of 89% to achieve SVR) that persisted at week 4. By week 12, serum HCV-RNA was undetectable (PPV 100%). Conclusions: Our data indicate that peginterferon α-2b plus ribavirin treatment produces significant changes in HCV dynamics that can be detected as early as 48 h after the first dose of peginterferon α-2b and that these changes are useful in predicting response to therapy in CHC patients.