Hepatitis C; early prediction of therapy response in patients and the benefits of treatment extension in non responders

Hepatitis C virus [HCV] has infected about 200 million individuals across the world and is known as the major cause of liver disease. Viral load measurement at early stages of the therapy in Hepatitis C patients is believed to be a more effective tool to predict the sustained virological response [SVR]. The primary aim of the present study was to evaluate whether the decline in viral load of HCV at early stages of the therapy may predict the treatment response. Another objective was to see the benefits of therapy extension in non-responders. Descriptive, analytical study. Shalamar Hospital Lahore. November 2010 to October 2013. Four hundred and thirty patients, chronically infected with different genotypes of Hepatitis C virus were treated with Interferon alpha 2b plus Ribavirin [IFN alpha-2b + RBV]. Viral load was assessed at day zero, week four, in the mid time of therapy and at the end of therapy. The treatment duration was extended 12-24 weeks [according to HCV genotypes] in non-responders. The patients with <2 MIU/ mL viral load at day zero, able to drop >/=2 log viral load at week-4 or showed no virus at the time of half therapy completion, exhibited better response. The extension of therapy was more beneficial for those non-responder who had <0.05 MIU/mL viral load at the end point of therapy than those who had >/=0.05 MIU/mL at that stage. The viral load detection at early stages of the therapy will be useful in clinical practice. Moreover, the patients with <0.05 MIU/ mL viral load at the end of therapy are suitable candidates for the therapy extension

Prevalence of hepatitis b surface antigen and anti hepatitis C virus; among general population in Lahore

Objective: To assess and compare the prevalence of hepatitis B and C in normal population. Design: This is a descriptive, non-interventional study. Setting: Data was collected from a free screening camp for hepatitis B and C at Shalamar Hospital, Lahore

Subjects and Methods: Normal people of any age and either sex were included in the study. Screening was performed for HBs Ag and Anti HCV by Acu-Check one step test [Chromatographic immunoassay] in serum

Results: A total 757 subjects were screened. Prevalence of HBs Ag was 2.6% and Anti HCV 13.5%. The mean age was 24.96+ 14.67 years. Females were 55.2% and males were 44.8%. Seroprevalence in females and males of Hbs Ag was 2.2% and 3.2% and of Anti HCV 15.6% and 10.9% respectively. HBs Ag was more prevalent in younger population [up to 10 years]. The majority of Anti HCV positive subjects were in 31-50 years age group

Conclusion: Seroprevalence of HBs Ag and HCV is high in general population. Prevalence of HCV is very high in this region and HBV is very high in children up to 10 years of age. Larger population based studies are needed to confirm the results