Original article
English
Bousifi N 1, Baghdadi I 1, Abubaker M 2, Tumi A 2.
1- Department of Infectious Diseases, Tripoli Central Hospital. 2 -Department of Internal Medicine , Tripoli Central Hospital.
Libyan J Infect Dis. 2009;3(1):50-56
Abstract
Background/Aims: A combination of pegylated interferon plus ribavirin is the treatment of choice for chronic hepatitis C (HCV), with a sustained virological response rate (SVR) of 63% in large multinational studies of naïve patients. HCV genotype is the main predictor of response, with lower SVR in genotypes 1 and 4 compared with genotypes 2 and 3. The present study was aimed to evaluate the SVR to Pegylated-interferon alpha-2a (PEGASYS®) plus ribavirin (COPEGUS®) in naïve patients, non-responders, and relapsers to conventional interferon plus ribavirin.
Patients and methods: One hundred and nine patients were consecutively treated from September 2003 to November 2005 for duration of 24 weeks to 48 weeks according to their HCV genotype. Liver biopsy was done for 92 patients within a year before starting therapy. All patients had baseline quantitative PCR and ALT level. Efficacy of Peg-interferon and ribavirin was prospectively evaluated, with assessment of end of treatment response (EOT), and SVR.
Results: EOT response was seen in 92/109 (84%) of patients. The SVR was available in 96 patients, out of whom 50 (52%) patients were males, mean age (41 years), and in whom the genotype distribution was as follows: genotype 1 (G1) 18 (19%), genotype 2 (G2) 26 (27%), genotype 3 (G3) 30 (31%), and genotype 4 (G4) 22 (23%). Normal ALT level was seen in 57 (59%), baseline quantitative PCR was >2 million copies/ml in 45 (47%) of patients. The overall SVR was seen in 65 (68%) patients. Nonresponse and relapse were seen in 17 (18%), and 14 (14%), respectively. The SVR according to genotypes was; G1 (28%), G2 (81%), G3 (77%), and G4 (68%). The SVR was achieved in 50/
62 (81%) naïve patients, 7/10 (70%) relapsers, but was achieved only in 8/24 (33%) of non-responders.
Conclusion: Pegylated-interferon in combination with ribavirin provides higher SVR rates in genotypes 2 and 3 than genotype 1. Patients who relapsed after therapy with conventional interferon plus ribavirin had better SVR than non-responders.
Keywords: Hepatitis C; pegylated interferon; ribavirin, therapy.
Link/DOI: