Abstract:
Objective To investigate potential predictive factors of relapse after antiviral treatment in patients with chronic hepatitis C virus (HCV) infection, and explore the temporal characteristics of relapse. Methods One-hundred-and-thirteen patients with chronic HCV received pegylated interferon and ribavirin combination therapy.HCV1 type was treated for 48 weeks and non-HCV1 types were treated for 24 weeks.Serum HCV RNA was measured with real-time quantitative reverse-transcription polymerase chain reaction.HCV genotypes were determined by sequencing of the HCV core-envelope1 region, followed by phylogenic analysis. Results The majority (88.5%, 100/113) of patients achieved virological response, and 14.0% (14/100) relapsed after stopping treatment.The rate of relapse was higher for HCV1 infections (21.6%) than for HCV2 (13.3%) , HCV3 (10.3%) , or HCV6 (5.3%) infections, but the differences were not statistically significant (P=0.345) .The rate of relapse was lower in patients ≤40 years old (10.8% vs >40 years old: 20.6%) , men (9.8% vs women: 20.5%) , and patients with elevated alanine aminotransferase (>80 U/mL: 8.6% vs 80 U/mL: 21.4%) , but the differences were not statistically significant (P=0.204, P=0.133, and P=0.068, respectively) .Patients with higher HCV RNA (14.3%) experienced similar relapse rates to those with lower HCV RNA (13.7%, P=0.936) .Patients who achieved complete rapid virological response (8.5%) had lower relapse rate than those with partial rapid virological response (23.1%) and those with no rapid virological response (33.3%) , while patients who achieved complete early virological response (13.7%) also had lower relapse rate than those with partial early virological response (50.0%) ;however, none of the intergroup differences were statistically significant (rapid: P=0.174 and early: P=0.148) .Most relapses occured in less than three months after stopping treatment, and no relapses occured more than six months after stopping treatment. Conclusion Relapse in chronic HCV patients occured within six months after discontinuation of pegylated interferon and ribavirin treatment.HCV patients, especially those with HCV1, should be carefully monitored by HCV RNA quantitative examination after stopping treatment to detect recurrence in a timely manner.