Purpose: To predict which chronic hepatitis C patients are likely to be late-responders we herein investigated the clinical characteristics of null-responders at 36 wk with hepatitis C virus (HCV) genotype Ib and a high viral load during the course of pegylated interferon (Peg-IFN)/ribavirin therapy. We compared the clinical characteristics (age gender body mass index previous treatment) and HCV RNA titer during the therapy between null-responders and responders. RESULTS: The HCV RNA clearance rate was 17.9% (24/134) 46.3% (62/134) 60.6% (86/142) 86.6% (123/142) and 88.0% (125/142) at 4 8 12 24 and 36 wk respectively. There were 17 patients (12.0%) who were still null-responders at 36 AZ-960 wk. There were no differences in the clinical characteristics between the responders and null-responders except for the titer and decline rates of HCV RNA at 1 wk and 4 wk. The HCV RNA titers at 1 wk and after 4 wk of treatment were significantly higher in the null-responders in comparison to the responders (<0.01). The serum HCV RNA titers of the responders decreased by 1.3 log after 1 wk of treatment and 1.6 log after 4 wk of treatment respectively. On the other hand the titers of the null responders decreased by only 0.5 log after 1 wk and 0.7 log after 4 wk of treatment respectively. The decrease rates of HCV RNA after 1 and 4 wk of treatment were significantly worse for null responders than for the responders (<0.01). CONCLUSION: The HCV RNA titer at 1 wk and 4 wk after initiating treatment may be useful for predicting null-responders to Peg-IFNα2b/ribavirin therapy. However further investigation is needed to determine the optimal time at which the decision to discontinue the Peg-IFNα2b/ribavirin AZ-960 therapy for null-responders can be made. value < 0.05 was considered significant. Rabbit Polyclonal to 5-HT-3A. RESULTS Clinical characteristics and response to therapy Patients’ characteristics are shown in Table ?Table1.1. The male: female ratio was 80:62. The mean patient age was 56.0 ± 10.0 years old (range 19-71). Mean body mass index was 25.3 ± 3.0 kg/m2. Ninety-seven patients were na?ve for IFN treatment and 45 patients had received previous treatment. Eighty-eight patients underwent a liver biopsy. Inflammatory activity was classified as A0: 0; A1:32; A2: 54; and A3: 2 patients and the fibrosis score was F0: 4; F1: 30; F2: 28; F3: 21; and F4: 5 patients respectively. At the end of the study (72 wk) the overall SVR rate of all patients was 60/142 (42.3%) that of responders was 60/125 (48.0%) and that of null responders was 0/17 (0.0%). Table 1 The characteristics of patients with chronic hepatitis C treated by pegylated interferon/ribavirin therapy Factors associated with a null response There were 17 patients (12.0%) who were null-responders at 36 wk. A comparison of the clinical characteristics between the responders and null responders is shown in Table ?Table2.2. There were no significant differences between responders and null responders with regard to gender age body weight body mass index previous treatment with IFN baseline HCV RNA amounts serum ALT amounts or stage of fibrosis (Desk ?(Desk2).2). Nevertheless the HCV RNA amounts at 1 wk and 4 wk after initiating treatment had been considerably higher in null responders (< 0.01). The null responders to Peg-IFNα2b/ribavirin got little if any reduction in the serum HCV RNA after 4 wk in therapy. The serum HCV RNA titers from the responders reduced by 1.3 log following 1 wk of treatment and 1.6 log after 4 wk of treatment respectively. Alternatively the titers from the null responders reduced by just 0.5 log after 1 wk and 0.7 log following 4 AZ-960 wk of treatment respectively. The reduce prices of HCV RNA after 1 and 4 wk of treatment had been considerably worse for null responders than for the responders (< 0.01). Desk 2 Comparison from the medical features between responders and null responders Dialogue The rules in Japan for the treating individuals with chronic hepatitis C advise that Peg-IFN/ribavirin treatment can be continuing for 72 wk in individuals who have continued to be positive for HCV RNA after 12 wk of treatment but who become adverse for HCV RNA after 13-36 wk on treatment. Predicated on these recommendations the individuals who are positive for HCV disease after 36 wk of treatment aren't recommended for long term therapy and really should cease the procedure when the normalization from the ALT level isn't achieved. We conducted this scholarly research to determine whether AZ-960 it's feasible AZ-960 to predict which.