Evaluation of molecular parameters for routine assessment of viremia in patients with chronic hepatitis C who are undergoing antiviral therapy.

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Evaluation of molecular parameters for routine assessment of viremia in patients with chronic hepatitis C who are undergoing antiviral therapy.

J Hum Virol. 1998 Jul-Aug;1(5):314-9. Unique Identifier : AIDSLINE MED/99211162
Kessler HH; Pierer K; Santner BI; Vellimedu SK; Stelzl E; Marth E; Fickert P; Stauber RE; Division of Clinical Molecular Diagnostics,; Karl-Franzens-University, Graz, Austria.; harald.kessler@kfunigraz.ac.at

Abstract: OBJECTIVE: To define the usefulness of molecular parameters in patients with chronic hepatitis C who are undergoing antiviral therapy. Anti-hepatitis C virus (HCV) treatment was monitored by determination of serum HCV load and by presence of HCV RNA in peripheral blood mononuclear cells (PBMCs). STUDY DESIGN/METHODS: Fifty-one patients with chronic hepatitis C undergoing antiviral therapy with interferon-alpha plus ribavirin were studied. Serum HCV RNA load was tested with a quantitative assay (Amplicor HCV Monitor Test) before, during, and up to 12 months after end of treatment. If HCV RNA was not detectable, serum samples were subsequently tested with a qualitative assay (Cobas Amplicor HCV Test) and corresponding ethylenediaminetetraacetic acid (EDTA)-treated blood was checked for presence of HCV RNA in peripheral blood mononuclear cells (PBMCs). Sustained virologic response was defined by loss of HCV RNA 12 months after the end of treatment. RESULTS: Four patients (7.8%) were found to be sustained virologic responders, 17 (33.3%) were transient virologic responders, and 30 (58.8%) were virologic nonresponders. No significant difference was found in the median pretreatment serum HCV RNA load between sustained virologic responders, transient virologic responders, and virologic nonresponders. At 1 month after start of therapy, HCV RNA was not detectable with both the serum and the PBMC assay in 12 (23.5%) of 51 patients. Four remained HCV RNA-negative until 12 months after the end of treatment. In 14 of 17 transient virologic responders, reappearance of HCV RNA was detected earlier in PBMCs than in serum. CONCLUSIONS: Based on these results in 51 patients, quantitation of baseline serum HCV RNA does not appear to be a decisive factor to the management of the individual patient. Early assessment of serum HCV RNA level after start of anti-viral treatment seems to be of major importance to identify virologic nonresponders. Reappearance of HCV RNA may be demonstrated earlier in PBMCs than in serum.

Keywords: JOURNAL ARTICLE Adult Aged Antiviral Agents/THERAPEUTIC USE Comparative Study Hepatitis C-Like Viruses/*GENETICS Hepatitis C, Chronic/DRUG THERAPY/*VIROLOGY Human Interferon-alpha/THERAPEUTIC USE Leukocytes, Mononuclear/VIROLOGY Middle Age Polymerase Chain Reaction/METHODS Ribavirin/THERAPEUTIC USE RNA, Viral/*BLOOD Time Factors Viral Load Viremia/*DIAGNOSIS
990730
A9971140

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