Predictive value of a rapid loss of serum RNA during interferon therapy in patients with chronic hepatitis C.

Interferon alpha (INF) used for chronic hepatitis C treatment induces a response in less than 25 % Of patients. The aim of this study was to appreciate the predictive value of the delay of clearance of hepatitis C virus (HCV viremia after onset therapy and to compare it with other virological markers such as viral load before treatment and viral type. Thirty one patients with chronic hepatitis C, treated with 3 MU Interferon, 3 times a week for 6 months, were followed until 6 months post-treatment. Response was defined according to the normalisation of transaminases levels and loss of HCV viremia. Five patients were long terme responder, eleven patients were complete to relapse responder and fiveteen patients were non responder, Serum I-ICV RNA level, HCV type and serial dectection of serum HCV RNA were determined and correlated with the long term response to INF. Patients with long term response had lower pre-INF viral road compared to the complete to relapse responder or to the non responder (p < 0.001). A rapid clearance of serum HCV RNA (1 month) is observed for all the long term responder (p < 0,001). The lowest viral load is also observed in these patients (p < 0 05). By contrast, although the number of patient is low, we were not able to observe a relation between the viral type and the response to treatment. In conclusion this data indicate that the delay of clearance of HCV RNA is also a good predictor of response to INF therapy. Furthermore a rapid clearance of HCV RNA in patients with a very weak pre-INF viral load is strongly associated with long term response (positive predictive value : 100%).