ORIGINAL ARTICLE Rapid, early and sustained virological responses in a cohort of Irish patients treated with pegylated interferon and ribavirin for chronic hepatitis C virus infection S. Sarwar • E. J. Ryan • M. Iqbal • P. A. McCormick • C. O’Farrelly • J. Hegarty Received: 11 July 2010 / Accepted: 8 October 2011 / Published online: 29 October 2011 Ó Royal Academy of Medicine in Ireland 2011 Abstract Background The response to the treatment with pegylated interferon (PEG IFN)-a combined with ribavirin in chronic hepatitis C virus (HCV) infection varies with some patients having a rapid or early response which is not sustained. Aims To investigate the rates of rapid virological response (RVR), early virological response (EVR) and sustained virological response (SVR) in an Irish cohort of HCV infected patients receiving IFN-a/ribavirin. Methods Rates of RVR, EVR and SVR were examined in 123 patients undergoing standard treatment for chronic HCV infec- tion between 2001 and 2007 at a Dublin Teaching Hospital. Results The rates of RVR, EVR and SVR in genotype 1 patients were 48, 68 and 50%, while in genotype 2/3 patients they were 87, 93 and 87%, respectively. The positive predictive values (PPV) of RVR for SVR in genotype 1 and genotype 2/3 patients were 90 and 92.4%, respectively. Conclusion The rates of response to PEG IFN-a/ribavirin in Irish patients are consistent with other international reports. We support the regular monitoring of rapid and early virological response as a standard of care in treating chronic hepatitis C patients. Keywords Hepatitis C Á Rapid early and sustained virological responses Á Predictive value Á Early viral kinetics Á Pegylated interferon-a Á Ribavirin Abbreviations RVR Rapid virological response EVR Early virological response ETR End of treatment response SVR Sustained virological response PPV Positive predictive value NPV Negative predictive value HCV Hepatitis C virus PEG IFN-a Pegylated interferon-a AST Aspartate aminotransferase ALT Alanine aminotransferase WCC White cell count Introduction Hepatitis C virus infection is a major health issue with almost 170 million people infected globally [1]. Chronic HCV infection leads to a wide spectrum of liver disease ranging from mild chronic hepatitis to advanced cirrhosis and hepatocellular carcinoma and is the primary indication S. Sarwar (&) Á M. Iqbal Á P. A. McCormick Á J. Hegarty Liver Unit, St Vincent’s University Hospital, Dublin 4, Ireland e-mail: shehzad32@hotmail.com M. Iqbal e-mail: miqbal70@hotmail.com P. A. McCormick e-mail: a.mccormick@ucd.ie J. Hegarty e-mail: jhegarty@svcpc.ie E. J. Ryan Á C. O’Farrelly School of Biochemistry and Immunology, Trinity College, Dublin 4, Ireland e-mail: Elizabeth.ryan.1@ucdconnect.ie C. O’Farrelly e-mail: cliona.ofarrelly@tcd.ie C. O’Farrelly School of Biochemistry and Immunology and School of Medicine, Trinity College, Dublin 2, Ireland 123 Ir J Med Sci (2012) 181:53–58 DOI 10.1007/s11845-011-0775-4