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Journal of Clinical Microbiology, August 2007, p. 2439-2445, Vol. 45, No. 8
0095-1137/07/$08.00+0     doi:10.1128/JCM.00577-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Response Prediction and Treatment Tailoring for Chronic Hepatitis C Virus Genotype 1 Infection{triangledown}

Magnus Lindh,1* Erik Alestig,1 Birgitta Arnholm,2 Anders Eilard,3 Kristoffer Hellstrand,1 Martin Lagging,1 Thomas Wahlberg,4 Rune Wejstål,1 Johan Westin,1 and Gunnar Norkrans1

Department of Infection and Virology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden,1 Infectious Diseases Clinic, Södra Älvsborg Skaraborg Hospital, Borås, Sweden,2 Infectious Diseases Clinic, Uddevalla Hospital, Uddevalla, Sweden,3 Infectious Diseases Clinic, Central Hospital, Skövde, Sweden4

Received 15 March 2007/ Returned for modification 12 May 2007/ Accepted 11 June 2007

We monitored early viral response during the treatment of hepatitis C virus (HCV) infection with the aim of identifying predictors of treatment outcome. We studied 53 patients with genotype 1 infection who received 180 µg/week pegylated interferon alfa-2a and 1,000 or 1,200 mg/day ribavirin depending on body weight and serially assessed HCV RNA in serum, using the Cobas TaqMan assay. Thirty-one patients (58%) achieved sustained viral response (SVR). SVR was obtained in 100% (10/10) of patients with pretreatment viremia concentrations below 400,000 IU/ml, in 100% (14/14) of patients with more than 1.5 log reduction of HCV RNA after 4 days of treatment, and in 95% (22/23) of patients with a rate of decline in viremia higher than 0.70 log units/week during the second phase. Non-SVR was seen in all patients with a second-phase decline rate lower than 0.35 log units/week. Patients with slopes between 0.50 and 0.80 log units/week achieved SVR (4/4) unless the treatment dose was modified (3/3). We conclude that the second-phase slope appears to be an accurate and useful predictor of treatment response. On the basis of these findings, we propose a model of tailored treatment which takes into account the second-phase slope and the amount of HCV RNA after 21 days of treatment.

* Corresponding author. Mailing address: Dept. of Virology, Guldhedsgatan 10B, 413 46 Göteborg, Sweden. Phone: 46 31 3424976. Fax: 46 31 827032. E-mail: magnus.lindh{at}microbio.gu.se

{triangledown} Published ahead of print on 20 June 2007.

Journal of Clinical Microbiology, August 2007, p. 2439-2445, Vol. 45, No. 8
0095-1137/07/$08.00+0     doi:10.1128/JCM.00577-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.





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