Response to combination therapy in hepatitis virus C genotype 2 and 3.
OBJECTIVE
To determine Sustained Viral Response (SVR) to Interferon (IFN) and ribavirin therapy in chronic hepatitis C patients of genotype 2 and 3.


METHODS
Case series.


METHODS
The Garden Clinic, Lahore, from June 1997 to August 2007.


METHODS
All patients of both genotypes 2 and 3 receiving combination therapy were included. Standard IFN with ribavirin was started in 648 (90%) patients of genotype 2 and 3, whereas 73 (10%), all genotype 3 received pegylated IFN. Outcome parameters including End of Treatment Response (ETR) [negative PCR at the end of therapy], sustained viral response (SVR) [negative PCR both at the end of treatment and 6 months later] and relapse (PCR negative at the end of treatment but positive 6 months later) were determined. Data were analyzed using student's t-test and Chi-square.


RESULTS
A total of 721 patients of genotype 2 and 3 were evaluated with male to female ratio of 1.78:1 and mean age 39.8 +/- 9.17 years. Twenty six (3.6%) patients were of genotype 2, while 695 (96.4%) had genotype 3. Six hundred and ten patients (84.6%) completed therapy, as per protocol, whereas 58 (8.04%) had therapy beyond 6 months. SVR was 72.7% with better outcome in genotype 2 (80%) than in 3 (72%) and in those on pegylated IFN and ribavirin (85%) than patients on standard IFN-based therapy (71.1%). Relapse was seen in 116 (16.1%) and 80 (11.1%) were non-responders. Patients with baseline ALT 2-4 x UNL had better SVR than patients with ALT < 2x UNL (p-value 0.01).


CONCLUSIONS
Genotype 3 was the predominant type of virus in the studied patients. SVR patients was 72.7%. Outcome was better with high baseline ALT and pegylated interferon combination therapy.
Khan
Anwar Ahmed
AA
Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore.
Sarwar
Shahid
S
D000328:Adult; D000963:Antimetabolites / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
D000963:Antimetabolites; D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons