Long term follow up of interferon treated chronic HCV patients in responders and non-responders

ABSTRACT

Interferon with ribavirin is the recommended treatment for chronic hepatitis C with a response rate ranging from 50-80% in different countries. Although sustained response is comparable to clinical cure, but whether interferon therapy slows down the disease process in non-responders and relapsers is not known. To determine the long term outcome of chronic HCV patients who have completed the interferon therapy and compare results between responders, relapsers and non-responders. Retrospective case record analysis of chronic hepatitis C patients who were treated with conventional interferon and ribavirin for 6 months during 1998 to 2002 and their follow up till 2011 were included. Depending upon the response they were divided into three groups i.e. responders, non responders and relapsers. A total of 175 patients were included. There were 126 [72%] males and 49 [28%] females, whose ages ranged from 11 to 70 years [mean 35.8 +/- 10.3]. After interferon therapy, 109 were sustained responders, 33 were relapsers and 33 non responders. Mean age of the responders [32.4 +/- 8.8 years] was significantly less as compared to non responders [40.4 +/- 12.0 years] and relapsers [42.4 +/- 8.0 years], [p < 0.05]. Responders had a much better follow up i.e four years as compared to non responders which was statistically significant[p <0.05]. During 10 years follow up, cirrhosis developed in 3 [2.8%] sustained responders, 6 [18.2%] non responders and 8 [24.2%] relapsers. During yearly followup, sustained responders had significantly lower mean ALT and AFP levels as compared to non responders and relapsers [p < 0.05] while non responders and relapsers had lower albumin levels as compared to the responders [p < 0.05]. Majority of the sustained responders had disease eradication, but non responders and relapsers should be followed for any evidence of cirrhosis