SVR Eradicates HCV

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SVR Eradicates HCV

SUSTAINED VIROLOGICAL RESPONSE IS ASSOCIATED WITH ERADICATION OF

HEPATITIS C VIRUS AND DECREASE IN ANTI-HCV TITER IN PATIENTS TREATED

FOR CHRONIC HEPATITIS C

Reported by Jules Levin

43rd Annual Meeting of the European Association for the Study of the

Liver

April 23-27, 2008, Milan, Italy

M. ot-Peignoux1, S. Maylin1, N. Boyer2, A.C. Cardoso1, M.P.

Ripault2, N. Giuily2, C. Castelnau2, M. Pouteau2, P. Bedossa3, P.

Marcellin1,2

1 INSERM, U-773, Centre de Recherche Biomédicale Bichat-Beaujon CRB3

Hôpital Beaujon, Clichy, 2 Service D'Hépatologie, Hôpital Beaujon,

Clichy, 3 Service D'Anatomie Pathologique, France

ABSTRACT

Background-Aim: Hepatitis C virus (HCV) eradication, in patients with

chronic hepatitis C who achieve a sustained virological response

(SVR), is still controversial. In this study performed in patients

with chronic hepatitis C who achieved an SVR, HCV-RNA was measured in

serum, peripheral blood mononuclear cells (PBMCs), liver and anti-HCV

antibodies titers were assessed, during follow-up.

Methods: 278 patients with an SVR after treatment with IFN alpha-2b

or PEG-IFN alpha-2b+ribavirin, were studied. HCV-RNA was tested: in

serum for all the 278 patients every year and at the time of PBMCs or

liver collection; in PBMCs in 71 patients 3.9±3.4 (0.5-10) years

after treatment; in liver 38 patients 3.2±1.6 (1-5) years after

treatment. HCV-RNA was detected with the VERSANT HCV-RNA Qualitative

assay (TMA). In 142 patients HCV antibody titers were measured with

the Axsym HCV 3.0 (Abbott), and with the third-generation HCV

recombinant immunoblot assay (RIBA) (CHIRON RIBA HCV 3.0 SIA), before

therapy and 4.7±2.2 (0.5 to 11) years after treatment. Liver

histology was assessed in 92 patients with paired biopsies 1.4±1.9 (0

to 10) years.

Results:

Patients were followed up for a mean of 3.5±2.4 years (range, 0.5-17)

years.

Serum HCV-RNA remained undetectable in all the patients (1050

samples).

None of the patients had detectable HCV RNA in the PBMCs or in liver.

The mean anti-HCV titers were 93±19 IU/ml and 45±21 IU/ml, before

therapy and

on the last serum sample available, respectively (p < 0001).

The most significant decrease was observed with anti-NS5 antibodies

(p = 0.001); anti-c22 antibodies remained unchanged.

Normal serum ALT levels were maintained in 94%, fibrosis stage was

improved in 57%, stable in 32%, deteriorated in 11% of the patients.

Regression of cirrhosis was observed in 7 of 10 patients.

Conclusion:

In our 278 patients with chronic hepatitis C and SVR, evaluated up to

17 years after treatment cessation, none demonstrated late relapse or

the presence of HCV RNA in serum, PBMCs or liver.

HCV antibody titers showed a marked decrease. These results

demonstrate a durable response to IFN alpha 2b or PEG-IFN alpha-

2b+ribavirin and indicate that SVR is associated with HCV eradication

and progressive decrease of anti-HCV.