title: Consensus interferon plus ribavirin for hepatitis C genotype 3 patients previously treated with pegylated interferon plus ribavirin.
abstract: BACKGROUND
  Not enough data are available about the effectiveness of consensus interferon (CIFN) among HCV genotype 3 patients who failed to respond to pegylated interferon and ribavirin.
  
  
  OBJECTIVE
  We aimed to assess the efficacy and safety of CIFN and ribavirin in non-responders and relapsers to pegylated interferon with ribavirin therapy.
  
  
  METHODS
  This open-label investigator-initiated study included 44 patients who received CIFN 15 µg /day plus ribavirin 800-1200 mg daily. In patients with an early virological response (EVR), the dose of CIFN was reduced to 15 µg thrice a week for further 36 weeks. Patients with delayed virological response continued to receive daily CIFN plus ribavirin to complete 48 weeks. The patients were considered "non-responders" if there were less than 2 log reduction in HCV RNA at 12 weeks and detectable HCV RNA at 24 weeks.
  
  
  RESULTS
  Twenty-four patients (55%) were non-responders and 20 patients were relapsers to the previous treatment with pegylated interferon plus ribavirin (mean age 43.6 ± 9.4 years, males 25 (57%)). Nine patients were clinically cirrhotic (Child A). End of treatment virological response was achieved in 19 (43.1%) patients and sustained virological response (SVR) occurred in 12 (27.3%). Out of these 12 patients, eight were non-responders and four were relapsers to the previous treatment. Advanced fibrosis or clinical cirrhosis was associated with low SVR. Adverse events were fever, myalgia, anorexia, depression, and weight loss. Two patients received granulocyte colony stimulating factor for transient neutropenia. Seven patients were given erythropoietin to improve hemoglobin, and six were treated for mild depression. Two patients developed portosystemic encephalopathy.
  
  
  CONCLUSIONS
  More than one-quarter of treatment-experienced patients with HCV genotype 3 achieved SVR after re-treatment with consensus interferon plus ribavirin.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Zaigham
authors.initials: Z
authors.lastname: Abbas
authors.affiliation: Postgraduate Medical Institute, Lahore, Pakistan.
authors.forename: Ghiasun Nabi
authors.initials: GN
authors.lastname: Tayyab
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Qureshi
authors.affiliation: Department of Medicine, Isra University Hospital, Hyderabad, India.
authors.forename: Mohammad Sadik
authors.initials: MS
authors.lastname: Memon
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Amna
authors.initials: A
authors.lastname: Subhan
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Tanzila
authors.initials: T
authors.lastname: Shakir
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
keywords: Genotype; Hepatitis C; Ribavirin; Treatment