Early HCV RNA values after interferon predict response

The aim of this study is to determine in patients infected with hepatitis C virus (HCV) whether early HCV RNA measurements at 48 hr following standard doses of interferon-alpha (IFN-alpha) (3 million IU) would predict response during six months of therapy. Twenty-three patients with HCV were treated with IFN-alpha 3 million IU three times a week and HCV RNA levels were quantified by branched-chain (b-)DNA analysis at baseline and 24 and 48 hr following IFN-alpha and at one, three, and six months. Mean baseline HCV RNA levels significantly declined from 6.0 +/- 1.6 Meq/ml at baseline to 2.4 +/- 0.7 Meq/ml 24 hr after IFN-alpha. However, HCV RNA values increased to 4.3 +/- 1.1 Meq/ml by 48 hr. Mean HCV RNA values at one and six months were not significantly lower than 48-hr values. In six patients in whom HCV RNA was negative by bDNA at 48 hr, three were negative by polymerase chain reaction at six months. Of the 17 patients who were positive by bDNA at 48 hr, all were positive at one and three months; and in the nine of nine who continued therapy for six months, there was no further decrease in HCV RNA levels. In patients receiving standard doses of IFN-alpha (3 million IU), serum RNA values 48 hr after the first injection predict long-term response.