Response guided interferon therapy for genotype 3 of chronic hepatitis C: compliance and outcome

ABSTRACT

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. 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. 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]. 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