Understanding the nature of early HCV RNA blips and the use of mathematical modeling of viral kinetics during IFN-based therapy

Abstract

In PNAS, Hsu et al. (1) observed an early transient increase (here, termed a blip) in hepatitis C virus (HCV) viral load in 92 out of 145 Taiwanese patients with chronic hepatitis C treated with pegylated IFN-α (IFN) and ribavirin and found that these blips were significantly associated with the outcome of therapy [i.e., sustained virologic response (SVR)]. Further, they sought to explain the origin and time of these blips using a version of a well-studied mathematical model of HCV infection and treatment (2) in a nonstandard way. Although these blips are interesting, several concerns need to be raised before further interpretation of the findings of Hsu et al. (1) is made.