title: Response to pegylated interferon alfa-2a and ribavirin in chronic hepatitis C genotype 4.
abstract: The safety and efficacy of pegylated interferon (PEG-IFN) alfa-2a and ribavirin were studied among patients treated for genotype 4 chronic hepatitis C. Ninety-five patients with chronic hepatitis C genotype 4 were treated with PEG-IFN alfa-2a (180 microg/week) plus ribavirin (> or =11 mg/kg/day) for 48 weeks. The primary end point was sustained virological response, defined as non-detectable levels of HCV RNA at the end of follow up (week 72). The proportion with sustained virological response was 58/95 = 61.1% (95% CI = 50.5-70.9%). Side effects were generally mild, well managed by dose reductions (in 62% of patients); in only two patients were side effects sufficiently severe to require treatment interruption. Ninety percent of patients adhered to treatment up to week 12, and their sustained virological response rate was higher compared to non-adherent (65% vs. 22%, respectively, P = 0.012). None of the patients who failed to achieve 1 log reduction of viral load by week 8 (n = 15), or 2 log reduction by week 12 (n = 17), had a sustained virological response. In conclusion, sustained virological response in genotype 4 Egyptian patients treated with PEG-IFN alfa-2a and ribavirin was estimated around 60%, intermediate between sustained virological response observed in genotype 1 and genotype 2-3 patients in Western countries. The early virological response (week 4 or week 8) should be investigated as a criterion to decide whether the patient may benefit from a shorter duration of therapy.
authors.affiliation: Faculty of Medicine, Department of Tropical Medicine and Hepatology, Cairo University, Cairo, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: El Makhzangy
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Said
authors.forename: Maissa
authors.initials: M
authors.lastname: Elraziky
authors.forename: Soheir
authors.initials: S
authors.lastname: Shouman
authors.forename: Rasha
authors.initials: R
authors.lastname: Refai
authors.forename: Claire
authors.initials: C
authors.lastname: Rekacewicz
authors.forename: Rita Raafat
authors.initials: RR
authors.lastname: Gad
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vignier
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Hamid
authors.forename: Khaled
authors.initials: K
authors.lastname: Zalata
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fontanet
authors.forename: Mostafa K
authors.initials: MK
authors.lastname: Mohamed
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004534:Egypt; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a