Role of HCV-RNA decay and IP-10 levels after 48 hours of standard HCV therapy as predictors of rapid virological response

Background and objectives: Rapid virological response (RVR) is a critical end-point in the era of the new direct-acting antiviral agents (DAA). The aim of this study was to evaluate the predictive value in achieving RVR of HCV-RNA load and IP10 after 48. hours of standard anti HCV therapy. Methods: HCV mono-infected and HIV/HCV co-infected patients naives to interferon were included. Demographic data, immune-virological HIV-related condition and HCV disease status were recorded before starting treatment. HCV-RNA and IP10 concentrations were also measured 48. hours after first interferon dose. Univariate model, logistic regression and ROC curve were performed for statistical analysis. Results: Thirty-two patients were enrolled (mean age 49.2 ± 5.6 years): all were treated with pegylated-interferon and ribavirin. Nineteen (59.3%) were HIV/HCV co-infected patients. RVR was reached in 10 patients (31.2%). A decline of more than two log of HCV-RNA after 48. hours of therapy was associated with RVR (P= 0.004). A trend was observed between increased IP10 levels at 48. hours and RVR (P= 0.08). In a multivariable model only HCV-RNA at 48. hours was associated with RVR (P= 0.011). ROC curve analysis for both HCV-RNA at 48. hours and IP-10 at 48. hours showed an area under the curve of 0.87 (95%CI: 0.74-1; P= 0.001) with specificity of 72.2% and sensibility of 90%. Conclusion: In HCV treatment-naïve patients HCV-RNA and IP10 determination after 48. hours of interferon and ribavirin may be a worthwhile endpoint to predict RVR and select patients that may not require DAA addition.