1. Antiviral effect of ribavirin in early non-responders to interferon monotherapy assessed by kinetics of hepatitis C virus RNA and hepatitis C virus core antigen.
- Author
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Lunel F, Veillon P, Fouchard-Hubert I, Loustaud-Ratti V, Abergel A, Silvain C, Rifflet H, Blanchi A, Causse X, Bacq Y, and Payan C
- Subjects
- Adult, Amantadine therapeutic use, Drug Therapy, Combination, Female, Hepacivirus genetics, Hepacivirus immunology, Hepatitis C Antigens blood, Hepatitis C, Chronic virology, Humans, Interferon alpha-2, Kinetics, Male, Middle Aged, Predictive Value of Tests, RNA, Viral blood, Recombinant Proteins, Retreatment, Treatment Outcome, Viral Core Proteins blood, Viral Load, Antiviral Agents therapeutic use, Drug Resistance, Viral, Hepacivirus isolation & purification, Hepatitis C, Chronic drug therapy, Interferon-alpha therapeutic use, Ribavirin therapeutic use
- Abstract
Background/aims: To evaluate the efficacy of ribavirin, given in second intention in non-responders to interferon alone, by studying viral kinetics., Methods: We conducted a trial including 203 patients with chronic hepatitis C, naïve of treatment. Patients were treated with interferon three times a week with or without ribavirin and amantadine according to response. Viral kinetics were assessed by serial measurements of HCV RNA (bDNA 3.0 and Monitor 2.0) and a new assay, trak-C, able to quantify total Hepatitis C virus (HCV) core antigen., Results: A significant initial drop in HCV RNA or HCV core antigen, under interferon alone, was associated with response to therapy, -4.85+/-1.33 log for HCV RNA in sustained responders versus -1.86+/-1.53 log for others groups, P<0.001. In patients receiving ribavirin in second intention, we also observed a similar drop in HCV RNA and HCV core antigen, predictive of sustained response, -2.67+/-1.26 log for HCV RNA in sustained responders versus -0.44+/-0.49 log in non-responders, P<0.001., Conclusions: Ribavirin has probably an additional antiviral effect in interferon treated patients. Kinetics of HCV RNA and HCV core antigen under treatment are highly predictive of a sustained virological response.
- Published
- 2003
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