Predicative factors for pegylated interferon-alpha plus ribavirin combination therapy in Egyptian patients with chronic hepatitis cinfected with genotype 4

Hepatitis C virus genotype 4 is a common infection in Egypt and is the leading cause of liver disease. Most reports suggest that predicative factors for the efficacy of interferon alpha and ribavirin combination therapy for chronic hepatitis patients could be due to the mutations in the interferon sensitivity determining region. The present study aimed to investigate the predictive factors for combined pegylated interferon-alpha and ribavirin therapy for chronic hepatitis patients with HCV genotype 4. The study was carried out on forty patients with genotype 4 chronic hepatitis C receiving a weekly dose of 180 microg of PEG -IFN-alpha in combination with RBV for 48 weeks. HCV RNA serumviremia levels were determined by a real-time polymerase chain reaction. The RNA samples were genotyped using specific primers for HCV genotype 4, and the interferon sensitivity determining region was amplified using polymerase chain reaction and sequenced. The amino acid sequence of the ISDR was compared with the published sequence for HCV 4 [GenBank: ABD75831.1]. Our data revealed that twenty one patients were responders [R; 52.2%], whereas 19 patients showed no-response [NR; 47.5%] to the combined pegylated interferon-alpha plus ribavirin therapy. The values of RNA titer in both responder and non-responder groups were statistically significant and could be used a predictive factor for combined pegylated interferon -alpha plus ribavirin efficacy. Other factors, such as gender, age, and interferon sensitivity determining region subtype were not related to its efficacy. These data collectively suggest that HCV RNA titer is an important factor for predicting the efficacy of pegylated interferon alpha plus ribavirin combination therapy in Egyptian patients with chronic HCV genotype 4