Prediction of efficacy to pegylated interferon-α-2b plus ribavirin in patients with genotype 2 hepatitis C virus using viral response within 2 weeks
Article first published online: 26 MAR 2013
© 2013 The Japan Society of Hepatology
Volume 44, Issue 2, pages 179–186, February 2014
How to Cite
Wada, Y., Tamai, H., Uno, A., Kawashima, A., Shingaki, N., Mori, Y., Moribata, K., Miyata, K., Higashi, K., Deguchi, H., Ueda, K., Inoue, I., Maekita, T., Iguchi, M., Kato, J. and Ichinose, M. (2014), Prediction of efficacy to pegylated interferon-α-2b plus ribavirin in patients with genotype 2 hepatitis C virus using viral response within 2 weeks. Hepatology Research, 44: 179–186. doi: 10.1111/hepr.12101
- Issue published online: 5 FEB 2014
- Article first published online: 26 MAR 2013
- Accepted manuscript online: 25 FEB 2013 09:38AM EST
- Manuscript Accepted: 18 FEB 2013
- Manuscript Revised: 28 DEC 2012
- Manuscript Received: 12 SEP 2012
- hepatitis C core antigen;
- pegylated interferon-α-2b;
- sustained virological response
Rapid virological response (RVR), defined as serum hepatitis C virus (HCV) RNA negativity at 4 weeks, is the most useful predictor of sustained virological response (SVR) to standard pegylated interferon (PEG IFN) plus ribavirin therapy for patients infected with genotype 2 HCV. The aim of the present study was to predict SVR using viral response within 2 weeks of therapy initiation.
Of 64 HCV genotype 2 patients with a high viral load treated with standard PEG IFN-α-2b plus weight-based ribavirin for 24 weeks, 58 patients whose adherence was more than 67% were analyzed. RNA and core antigen levels were measured at four time points: the day of therapy initiation, the following day, and at 1 and 2 weeks.
SVR was achieved in 73% (47/64) of patients. Univariate analysis of SVR contributing factors showed significant differences with age, bodyweight, white blood cell count, platelet count, fibrosis marker levels, baseline core antigen level and viral response. The area under the receiver–operator curve (AUC) of the core antigen level at 1 week (AUC, 0.940) was the highest among the significant SVR predicting factors. Setting 100 fmol/L as the cut-off value for core antigen level at 1 week, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for predicting SVR were 100%, 86%, 96%, 100% and 97%, respectively, and for predicting RVR were 66%, 93%, 97%, 46% and 72%, respectively.
The HCV core antigen level at 1 week after therapy initiation is the most useful predictor for SVR.