Editor-in-Chief, HCV Advocate Print this page Utilization of Virologic Testing in the Treatment of Chronic

Slightly fewer than half of patients with chronic hepatitis C fail to eradicate hepatitis C virus (HCV) when treated with the current regimen of combination therapy with pegylated interferon and oral ribavirin (PEG-R). (1,2) With past treatment regimens including interferon monotherapy or the combination of standard interferon with ribavirin, patients who remained HCV RNA positive by qualitative testing by RT-PCR after 12 or 24 weeks, respectively, had little or no chance of achieving a sustained virologic response (SVR). (3,4) Preliminary data from one of the PEG-R studies suggested that the most appropriate time point for assessing response with the current regimen was also 24 weeks. (1). Thus, treatment could be discontinued early in viral non-responders, saving them the inconvenience and expense of the latter half of the treatment course. However, several papers also reported that the lack of an even earlier reduction in viral level was predictive of non-response despite continued treatment. (5,6) Unfortunately, these reports examined small numbers of patients and used quantitative assays for HCV RNA that were neither reliable or commercially available. Recently, several standardized commercial assays for quantitating HCV RNA have become available. The role of these quantitative tests in assessing early virologic response (or non-response) to PEG-R has not been studied. The goal of the current analysis was to determine whether reduction of the level of HCV RNA during the firs