RESPONSE OF HEPATITIS C PATIENTS TO ALPHA INTERFERON AND RIBAVIRIN COMBINATION THERAPY

Background: Hepatitis C virus infection is the major cause of chronic hepatitis in Pakistan. The aim of this study was to determine the response of patients with chronic hepatitis C to interferon and ribavirin combination therapy as initial treatment in our setup. Material & Methods: It was an experimental study conducted from January 1997 to December 2001 at Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar. Non-cirrhotic chronic hepatitis C adult patients having no evidence of decompensated cirrhosis were treated with interferon and ribavirin combination for 24 weeks. Eligible patients had abnormal serum aminotransferase concentrations for six months before the start of treatment and they were positive for HCV antibodies by third generation ELISA, with positive serum HCV RNA. Serum HCV RNA was performed before treatment, at 12 weeks, at the end of treatment and at 24 weeks after the end of treatment. Patients were assessed for efficacy and side effects of therapy. Results: Three hundred and eighteen patients with chronic hepatitis C were treated during the study period with 229 (72%) males and 89 (28%) females of adult age group. Five (1.57%) patients lost follow up and three (0.94%) patients left treatment because of adverse effects of drugs. The serum HCV RNA became undetectable in 222 (71.62%) patients at 12 weeks (EVR). It was 267 (81.12%) at the end of 24 weeks (ETR) and 242 (78.06%) at 24 weeks after the completion of treatment (SVR). All the patients with negative serum HCV RNA at 12 weeks had also negative serum HCV RNA at the end of treatment as well. The ALT decreased during treatment, became normal at 12 weeks in those patients who had lost HCV RNA after 12 weeks of treatment and remained normal at the end of treatment. White cell count and hemoglobin decreased during treatment and became normal after the completion of treatment. Two patients stopped treatment because of decreased hemoglobin and one because of neutropenia. No other significant adverse effects were noted in our patients. In the rest of patients, the side effects were flue like symptoms, which occurred in all patients. Conclusion: Treatment of hepatitis C by combination of interferon and ribavirin for 24 weeks has highsustained virological response with fewer side effects in our set up.