Halfon Philippe, Khiri Hacene, Tran Albert, Pénaranda Guillaume, Courcambeck Jerome, Joly Hélene, Ouzan Denis
Virological Department, Alphabio Laboratory, Marseille, France.
Eur J Gastroenterol Hepatol. 2003 Oct;15(10):1067-71. doi: 10.1097/01.meg.0000085472.12407.49.
An early virological response has been shown to be predictive of a sustained virological response to antiviral treatment in chronic hepatitis C infection. The aim of the study was to analyse viral kinetics during the first 6 weeks of treatment (interferon plus ribavirin) in 18 relapsed hepatitis C patients after a first course of interferon monotherapy.
We studied 18 relapsed patients treated with interferon and ribavirin. A sustained virological response (negative HCV RNA measured by polymerase chain reaction 6 months after the end of therapy) was obtained in 12 patients. Samples were obtained before therapy and each week for 6 weeks during therapy; HCV RNA levels were determined using quantitative bDNA.
At the end of week two, a viral-load drop of more than 2.20 log was observed in all the 12 patients with a sustained virological response and in none of the six other patients. When we considered the median of the viral load reduction from baseline for each week of treatment, week two appeared to be the time point most predictive of a sustained viral response (positive predictive value 83%; negative predictive value 92%).
During treatment with interferon plus ribavirin in relapsed hepatitis C patients, viral kinetics showed that the second week of treatment appeared to be the time point most predictive of a sustained viral response.
早期病毒学应答已被证明可预测慢性丙型肝炎感染对抗病毒治疗的持续病毒学应答。本研究的目的是分析18例在首次使用干扰素单药治疗后复发的丙型肝炎患者在治疗的前6周（干扰素加利巴韦林）期间的病毒动力学。
我们研究了18例接受干扰素和利巴韦林治疗的复发患者。12例患者获得了持续病毒学应答（治疗结束6个月后通过聚合酶链反应测得HCV RNA阴性）。在治疗前以及治疗期间每周采集样本，持续6周；使用定量分支DNA测定HCV RNA水平。
在第2周结束时，所有12例获得持续病毒学应答的患者均观察到病毒载量下降超过2.20 log，而其他6例患者均未出现这种情况。当我们考虑治疗各周病毒载量较基线下降的中位数时，第2周似乎是最能预测持续病毒应答的时间点（阳性预测值83%；阴性预测值92%）。
在复发的丙型肝炎患者接受干扰素加利巴韦林治疗期间，病毒动力学显示治疗的第2周似乎是最能预测持续病毒应答的时间点。
