Measuring HCV RNA and assessing virologic response

Abstract

HCV RNA quantification was initially used to improve our knowledge of HCV infection and related liver diseases: HCV RNA level at baseline was shown to be an independent predictor of the outcome of therapies based on the use of interferon-α; mathematical modeling of viral decay during antiviral therapy has improved our understanding of the biology of HCV infection; monitoring of HCV RNA level kinetics during IFN-α-based therapy was shown to predict the likelihood of a favorable outcome and was subsequently used to tailor treatment duration in order to optimize the results of treatment. HCV RNA quantification assays based on “real-time” PCR are now widely used. Recent data with direct acting antiviral drugs in combination with pegylated interferon-α and ribavirin suggest that monitoring of viral kinetics will be useful to tailor treatment duration when these combinations are available. The future utility of HCV RNA level monitoring in interferon-free treatment regimens remains to be established.