238. Sustained Virological Response Is Associated with Eradication of
Hepatitis C Virus and Decrease in anti-HCV Titer in Patients Treated for
Chronic Hepatitis C with Interferon alpha 2b or Pegylated Interferon
alpha-2b+ribavirin.

S. Maylin; M. Martinot-Peignoux; N. Boyer; M. Ripault; A. C. Cardoso; N.
Giuily; C. Castelnau; M. Nicolas-Chanoine; P. Marcellin

It is unclear whether hepatitis C virus (HCV) is eradicated in patients with
chronic hepatitis C who achieve a sustained virological response [SVR). In
this study, HCV-RNA was measured in serum, and peripheral blood mononuclear
cells (PBMCs) and a follow-up of anti-HCV antibodies were performed in
patients with chronic hepatitis C who achieved an SVR.

PATIENTS-METHODS:

215 patients with an SVR after a treatment with IFN alpha-2b or PEG-IFN
alpha-2b+ribavirin (PEG-IFN 1.5?g/kg/week, plus ribavirin 800-1200 mg /day
according to weight), were included in this study. HCV-RNA was tested: -(1)
in serum for all the 215 patients every year and at the time of PBMCs
collection, -(2) in PBMCs collected in 71 patients 3.9±3.4 (0.5-10) years
after treatment. HCV-RNA was detected with the VERSANT HCV-RNA Qualitative
assay (Qual TMA, Siemmens) (sensitivity 10 IU/ml). In 70 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).

RESULTS:

Patients were followed up for a mean of 2.7±1.4 years (range, 0.5 -10)
years. Serum HCV-RNA remained undetectable in all the patients (1125
samples). HCV-RNA was detectable in the PBMCs sample for 1 patient (3 years
after treatment cessation). The kinetics of antibodies is shown on the
figure. The mean titers were 93±20 IU/ml and 41±20 IU/ml, before therapy and
on the last serum sample available, respectively (p<0001). A significant
decrease was observed for anti-NS5 and anti-NS3 with the RIBA assay
(p=0.01).

CONCLUSION:

In our 215 patients with chronic hepatitis C and SVR, evaluated up to 10
years after treatment cessation, none demonstrated late relapse. HCV-RNA was
detectable, by a very sensitive assay (TMA), in PBMCs in 1 patient. 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