Response of hepatitis c virus infected patients to interferon therapy in sharkia

Chronic hepatitis C represents major cause of chronic liver disease in Egypt.Approximately 25% of patients with HCY infection will have hepatic fibrosis that evolved into cirrhosis.Infact chronic HCY IS the leading indication for liver transplanatation in the united states and is responsible for an estimated 8000-10.000 deaths each year. Although a number of therapeutic trials have been shown that interferon is effective in inducing the remission of chronic hepatitis C, the long term benefit of interferon is not known.The combination therapy uf interferon alfa-2b plus ribavirin IS superior to interferon alfa-2b alone.Peginterferon alfa-2a offered enhanced sustained virologic response In all patients, regardless of HCY genotype and viral load, and a once¬weekly dosing schedule.This study was conducted to evaluate the etlicacy of interferon therapy for patients with chronic hepatitis C with or without liver cirrhosis. The follow up period :tfter the end of interferon therapy was 1 year.Forty patients in the present study were classified into 4 groups:Group 1: 10 patients ”chronic HCY” received antioxidant for 2 years.Group II: 10 patients ”chronic HCV” received interferon alfa-2b + ribavirin for 6 months and followed up after I year.Group Ill: 10 chronic HCY patients recei ved interferon alfa-2b + ribavirin for I year and followed up after I year.Group IV: 10 chronic HCV patients received peg interferon a-2a + ribavirin for 6 months and followed up after 1 year.Personal history was taken and full clinical examination was done to each patients.Laboratory investigations include liver function tests: AST, ALT, PT, albumin, total and direct bilirubin. Kidney function tests: urea and creatinine. Abdominal ultrasonography. Liver biopsy was done before treatment. HBsAg, HIV detection by ELISA. Quantitative PCR for HCV¬RNA level before and after interferon therapy and at the end of the period of follow up (1 year).Results:- Patients who received interferon alfa-2b + ribavirin for 6 months showed 40% biochemical end treatment response and 20% sustained biochemical response. The virological end treatment response was 30% and the sustained virological response was 10%.- Patients who received interferon alfa-2b + ribavirin for I years showed 40% biochemical end treatment response and 20% sustained biochemical response at the end of follow up period (1 year). The virological response was 30% at the end treatment and 20% sustained virological response at the end of follow up period (1 year).- Patients who received peg interferon alfa-2a + ribavirin for 6 month showed 60% biochemical end treatment response and 50% sustained biochemical response at the end of follow up period (I year). The virological response was 50% at the end of treatment and 30% at the end offollow up period (1 year).Peginterferon alfa-2a + ribavirin is better than interferon alfa-2b + ribavirin either in achievement of biochemical and virological end treatment response or sustained response for chronic HCY.1- Peginterferon afla-2a in a dose of 180 ug once weekly plus ribavirin for 48 weeks is a suitable regimen for treatment of Egyptians with HCY infection.2- Further studies are needed CO evaluate the efficacy of peginterferon alfa¬2a therapy in relation to HCY genotyping in Egyptians.