Response to combination therapy in hepatitis virus C genotype 2 and 3

ABSTRACT

To determine Sustained Viral Response [SVR] to Interferon [IFN] and ribavirin therapy in chronic hepatitis C patients of genotype 2 and 3. The Garden Clinic, Lahore, from June 1997 to August 2007. All patients of both genotypes 2 and 3 receiving combination therapy were included. Standard IFN with ribavirin was started in 648 [90%] patients of genotype 2 and 3, whereas 73 [10%], all genotype 3 received pegylated IFN. Outcome parameters including End of Treatment Response [ETR] [negative PCR at the end of therapy], sustained viral response [SVR] [negative PCR both at the end of treatment and 6 months later] and relapse [PCR negative at the end of treatment but positive 6 months later] were determined. Data were analyzed using student's t-test and Chi-square. A total of 721 patients of genotype 2 and 3 were evaluated with male to female ratio of 1.781 and mean age 39.8 +/- 9.17 years. Twenty six [3.6%] patients were of genotype 2, while 695 [96.4%] had genotype 3. Six hundred and ten patients [84.6%] completed therapy, as per protocol, whereas 58 [8.04%] had therapy beyond 6 months. SVR was 72.7% with better outcome in genotype 2 [80%] than in 3 [72%] and in those on pegylated IFN and ribavirin [85%] than patients on standard IFN-based therapy [71.1%] Relapse was seen in 116 [16.1%] and 80 [11.1%] were non-responders. Patients with baseline ALT 2-4 x UNL had better SVR than patients with ALT < 2x UNL [p-value 0.01]. Genotype 3 was the predominant type of virus in the studied patients. SVR patients was 72.7%. Outcome was better with high baseline ALT and pegylated interferon combination therapy