Sustained virological response is associated with clearance of hepatitis C virus RNA and a decrease in hepatitis C virus antibody

Sarah Maylin,Tarik Asselah,Patrick Marcellin,Corinne Castelnau,Ana Carolina Cardoso,Michelle Pouteau,Nathalie Giuily,Nathalie Boyer,Marie-Pierre Ripault,Michelle Martinot-Peignoux,Marie Hélène Nicolas-Chanoine,Rami Moucari

doi:10.1111/j.1478-3231.2008.01918.x

Sarah Maylin, Tarik Asselah + Show 10 more

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https://doi.org/10.1111/j.1478-3231.2008.01918.x

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Abstract

Background/AimViral eradication in chronic hepatitis C patients with sustained virological response (SVR) after interferon (IFN) therapy remains controversial.MethodsDuring a long-term follow-up study, 157 patients with SVR to IFN-α-2b-based therapy were investigated with a transcription-mediated amplification (TMA) assay in serum. The hepatitis C virus (HCV) antibody was assessed by measuring the optical density (OD) (Axsym HCV v3.0) and the semiquantitative titres (RIBA HCV v3.0) of the HCV antibodies directed against the core, NS3, NS4 and NS5 proteins. A control group included 23 untreated patients with persistently normal serum alanine aminotransferase and detectable serum HCV-RNA.ResultsThe median duration of follow-up was 4.0 (0–10) years. Serum HCV-RNA remained undetectable in all patients. The mean HCV antibody OD were 93 ± 19 and 45 ± 21 before therapy and in the last available serum sample respectively (P=0.001). There was a marked decrease in the HCV antibodies directed against the NS3, NS4 and NS5 proteins (P=0.001), while the core protein titre remained strongly positive. The 23 control patients were followed for a median of 5 (2–14) years. The mean HCV antibody OD were 65 ± 14 and 64 ± 19 in the first and the last measurements, respectively (NS), and HCV antibody titres for structural and non-structural proteins remained unchanged.ConclusionThis long-term study evaluating 157 patients demonstrated that SVR assessed by TMA is durable, and HCV antibodies were markedly decreased (mainly those directed against the non-structural proteins), emphasizing an absence of ongoing infection. These results strongly suggest that HCV infection cured in patients who achieve an SVR.

Highlights

The goal of antiviral therapy in patients with chronic hepatitis C virus (HCV) infection is to attain a sustained virological response (SVR), resulting in viral eradication in most patients [1]
The liver is the main site of viral replication, HCV may be found in extrahepatic locations such as peripheral blood mononuclear cells (PBMC) [9]
Several studies have been performed to define the features of the humoral immune response to HCV infection; only a few small studies have focused on the dynamics of change in HCVspecific antibodies in relation to treatment-induced viral eradication [16,17,18]

Summary

Introduction

The goal of antiviral therapy in patients with chronic hepatitis C virus (HCV) infection is to attain a sustained virological response (SVR), resulting in viral eradication in most patients [1]. Two recent studies [8,9,10,11,12,13] have reported the absence of detectable HCV-RNA in the PBMC and/or the liver in patients with SVR achievement after antiviral therapy. Several studies have been performed to define the features of the humoral immune response to HCV infection; only a few small studies have focused on the dynamics of change in HCVspecific antibodies in relation to treatment-induced viral eradication [16,17,18]. The aim of the present study was to investigate the dynamics of change in various HCV antibodies in patients with chronic hepatitis C who achieved SVR after antiviral therapy

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