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Preliminary Study Results Show HCV in Blood Reflects HCV in Liver Cells

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    NATAP - www.natap.org DDW Conference May 2001, Atlanta Reported by Jules Levin Preliminary Study Results Show HCV in Blood Reflects HCV in Liver Cells In HCV
    Message 1 of 1 , Jul 8, 2001
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      NATAP - www.natap.org

      DDW Conference
      May 2001, Atlanta
      Reported by Jules Levin

      Preliminary Study Results Show HCV in Blood Reflects
      HCV in Liver Cells

      In HCV you frequently here that HCV can be cured as
      opposed to HIV. HIV
      requires continuous therapy to control HIV viral load.
      In HCV, therapy
      is for
      a limited defined period of time, usually one year.
      Several studies
      show that
      in HCV, if a patient has negative HCV viral load 6
      months after
      stopping
      therapy (called a sustained virologic response) about
      95% of the
      patients
      sustain PCR negativity 3-11 years of follow-up. This
      suggests that HCV
      is
      different than HIV and may be curable for some
      patients. A frequently
      asked
      question, since we talk about a cure in HCV, is does
      reduction or
      "elimination" of HCV viral load in blood correlate
      with what is seen in
      the
      liver cells. The preliminary results of this study
      suggest yes, what
      you see
      in the blood correlates with what you see in the
      liver, suggesting that
      if
      you attain PCR negativity 6 months after stopping
      treatment and sustain
      that
      you should see the same in the liver cells. Further
      investigation is
      needed
      and as time goes by we will be accumulating more data
      as more patients
      are
      treated and we have longer follow-up. But a small
      study reported at DDW
      2000
      reported similar findings with longer follow-up I
      think.

      PLASMA HEPATITIS C VIRUS (HCV) RNA IS COMPARABLE TO
      HEPATIC HCV RNA
      WHEN
      OBTAINED WHILE ON THERAPY AT THE END OF TREATMENT AS A
      PREDICTOR OF
      SUSTAINED
      RESPONSE IN PATIENTS WITH CHRONIC HEPATITIS C
      INFECTION

      Lino J. Deguzman, Jose M. Nieto, Arrowhead Regional
      Medical Ctr,
      Colton, CA;
      Shelley A. Deguzman, Inland Empire Digest Disease &
      Liver Ctr,
      Redlands, CA;
      Andrew Conrad, National Genetics Institute, Culver
      City, CA; Bradley
      Collins,
      Arrowhead Regional Medical Ctr, Colton, CA

      Introduction: Plasma HCV RNA PCR (HCVPCR) is the
      standard used to
      determine
      sustained response (SR) to interferon (IFN) +/-
      ribavirin. We need to
      determine if other reservoirs of HCV are more reliable
      in predicting
      SR. The
      aim of this prospective study was to see if plasma or
      peripheral blood
      mononuclear cell (PBMC) HCVPCR could serve as a
      non-invasive comparison
      to
      hepatic HCV PCR in predicting SR at the end of
      treatment (TX) just
      prior to
      cessation of TX. METHODS: 38 pts (19 males)with
      chronic HCV were TX. 20
      pts
      received std dose Rebetron or induction dose IFN +
      Ribavirin and 18 pts
      received IFN monotherapy (3-5MU QD-QOD). The median
      age was 47 and 47%
      (18/38) were genotype 1. 26 pts were naive and 12 were
      previously TX.
      All pts
      had a baseline and a 12 month end-of-TX liver biopsy.
      Using the
      Superquant
      Method (NGI), quantitative HCVPCR was simultaneously
      measured on the
      plasma,
      PBMC and hepatic tissue. Results: The PPV and
      specificity was 100% in
      all 3
      reservoirs. Conclusion: As expected,the highest
      negative predictive
      value
      (NPV) or the highest likelihood for a SR was
      consistently seen in the
      naive
      and genotype non-1 pts in all three reservoirs. It is
      unclear however,
      why
      pts treated with IFN monotherapy had a higher NPV than
      pts TX with
      Rebetron.
      From this data, it appears that quantitative plasma
      HCVPCR routinely
      used
      today closely mimics hepatic HCVPCR in determining
      response to
      antiviral
      therapy. Measurement of hepatic HCVPCR does not seem
      to add additional
      information that plasma HCVPCR already provides.

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