Abdul-Nasser Y. Elzouki; Mohamad B. All; Mustafa Alturki
Department of Medicine, Faculty of Medicine, Garyounis University, Benghazi, Libya
Garyounis Medical Journal Vol. 22, No.1. 2005:1-7
Background: The combination therapy with interferon-alfa and ribavirin is the standard treatment of chronic hepatitis C virus (HCV) infection. However, the response rate varies widely in patients from different parts of the world, reflecting differences in the natural history of the disease and the immune reactivity of the population studied. Objective: The aim of the present study was to assess the efficacy of the combination of recombinant interferon-alfa and ribavirin in the treatment of naïve Libyan patients with chronic HCV infection.
Materials & Methods: Seventy adult Libyan patients with chronic HCV infection were treated for 12 months. All patients had abnormal serum transaminase levels and were anti-HCV antibodies positive by a third generation enzyme linked immunosorbent assay (ELISA) and HCV-RNA positive by polymerase chain reaction (PCR) before initiation of the treatment. Pretreatment liver biopsy specimens were available from 20 patients (29%) and pathologic changes were graded by Metavir score system.
Results: Forty-four (63%) patients had responded to the treatment as evident by normalization of serum transaminases and loss of the HCV-RNA at the end of treatment. When the responded patients ( n = 44) were followed for six months after completing therapy, 26 of them (37%) still have a sustained loss of HCV-RNA. HCV-genotyping was performed in 18 of the non-sustained responders and 67% (12/26) were found to have genotype 4 and the other six (33%) were found to have genotype lb. Some reversible side effects of treatment were reported and there were no episodes of hepatic decompensation or deaths during the study period.
Conclusion: The combination therapy with interferon-alfa and ribavirin, for 12 months induces virologic improvement and has an acceptable safety profile in the treatment of naive Libyan patients with chronic HCV infection. The effect of the treatment on the sustained response rate depends on pretreatment levels of viremia and probably the HCV-genotyping.
Keywords: HCV, Libya, anti HCV, HCV-RNA, HCV-genotyping