title: Response Guided Interferon Therapy for Genotype 3 of Chronic Hepatitis C: Compliance and Outcome.
abstract: OBJECTIVE
  To determine compliance and improvement in sustained viral response (SVR) by following response guided therapy (RGT) plan of interferon and ribavirin, for genotype 3 in chronic hepatitis C.
  
  
  METHODS
  Patients with chronic hepatitis C genotype 3, who were eligible for interferon-ribavirin therapy and consented for RGT, were included. Those with no rapid viral response (RVR), having coarse echotexture of liver or undergoing re-treatment, were advised 48 week treatment whereas, rest had 24 week standard therapy. PCR for HCV RNA checked 6 months after discontinuing treatment, was the primary end point of study.
  
  
  RESULTS
  Of 154 patients, included in the study with mean age of 39.9 (±10.84) and male to female ratio 1.4/1 (94/60), majority of patients, 136 (88.4%) were treatment naïve whereas, 18 (11.6%) were being retreated. On ultrasound, 63 (40.9%) patients had coarse liver and 33 (21.4%) had splenomegaly. RVR was achieved in 99 (64.3%) patients. Overall 66(42.8%) patients merited extended duration of therapy as per RGT plan but only 22 (33%) were compliant. Treatment related side effects were the dominant reason for declining RGT in 33 (75%) patients. SVR was noted in 111 (72.1%) patients. Those patients with extended therapy (RGT), had SVR 90.9% (20/22), although, better but statistically not significant than those who stopped therapy at 6 months 77.2% (34/44) (p value 0.11).
  
  
  CONCLUSIONS
  Response guided therapy plan did not improve SVR to pegylatedinterferon and ribavirin therapy in patients with genotype 3 and it has low patient compliance due to treatment related side effects.
authors.affiliation: Shahid Sarwar, FCPS (Medicine) FCPS (Gastroenterology) Associate Professor of Medicine Gujranwala Medical College Consultant Gastroenterologist Doctors Hospital and Medical Center (DHMC) Lahore.
authors.forename: Shahid
authors.initials: S
authors.lastname: Sarwar
authors.affiliation: Anwaar A. Khan, MACP, FACG, FRCP, AGAF, FCPS Ex- Dean and Professor of Gastroenterology, ShaikhZayed Post Graduate Medical Institute, Lahore, Pakistan Consultant GastroenterologistDHMC, Lahore, Pakistan.
authors.forename: Anwaar A
authors.initials: AA
authors.lastname: Khan
authors.affiliation: Shandana Tarique, FCPS (Medicine) Associate Professor of Medicine, Gujranwala Medical College, Pakistan.
authors.forename: Shandana
authors.initials: S
authors.lastname: Tarique
keywords: Chronic hepatitis C; Compliance; Genotype 3; Response guided therapy; Sustained viral response (SVR)