Kinetics of hepatitis C virus RNA load during pegylated interferon plus ribavirin therapy in treatment-naive Chinese patients

Background/Aims: To investigate the viral kinetics of Chinese CHC patients received pegylated interferon plus ribavirin and examine the impact of HCV genotypes and severity of liver disease. Methodology: 65 treatment-naove CHC patients who finished a 24-week therapy with peginterferon. alpha-2b (1.5mcg/kg/week) plus ribavirin (1000-1200mg /day) and 24 weeks of follow-up were enrolled. Hepatic fibrosis was graded by the METAVIR scoring system. Serum quantitative HCV RNA was determined by Versant HCV RNA 3.0 assay (Bayer Inc.). Results: Genotype non-1 patients responded quickly and a higher percentage of them achieved undetectable HCV RNA (<615 IU/mL) at week 4 compared with genotype I patients (93% vs. 69%, p=0.018). Degree of hepatic fibrosis significantly affected end-of-treatment and sustained response (SVR). For patients who did not achieve early virological response (EVR), the negative predictive value for SVR was 100%. In genotype 1 patients, undetectable HCV RNA by week 4 was a good marker to predict treatment response, with a positive predictive value of 84% and a negative predictive value of 82%. Conclusions: EVR can be applied to Chinese patients as an early stopping rule. A 24-week duration of pegylated IFN/ribavirin might be adequate for genotype 1 patients who rapidly responded to therapy.