Response to combination therapy in hepatitis virus C genotype 2 and 3. 2009

Anwar Ahmed Khan, and Shahid Sarwar
Department of Gastroenterology, Shaikh Zayed Postgraduate Medical Institute, Lahore.

OBJECTIVE To determine Sustained Viral Response (SVR) to Interferon (IFN) and ribavirin therapy in chronic hepatitis C patients of genotype 2 and 3. METHODS Case series. METHODS The Garden Clinic, Lahore, from June 1997 to August 2007. METHODS 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. RESULTS A total of 721 patients of genotype 2 and 3 were evaluated with male to female ratio of 1.78:1 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). CONCLUSIONS 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.

UI MeSH Term Description Entries
D007372 Interferons Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. Interferon
D008297 Male Males
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D005838 Genotype The genetic constitution of the individual, comprising the ALLELES present at each GENETIC LOCUS. Genogroup,Genogroups,Genotypes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000963 Antimetabolites Drugs that are chemically similar to naturally occurring metabolites, but differ enough to interfere with normal metabolic pathways. (From AMA Drug Evaluations Annual, 1994, p2033) Antimetabolite
D000998 Antiviral Agents Agents used in the prophylaxis or therapy of VIRUS DISEASES. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. Antiviral,Antiviral Agent,Antiviral Drug,Antivirals,Antiviral Drugs,Agent, Antiviral,Agents, Antiviral,Drug, Antiviral,Drugs, Antiviral
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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