Faiqa Fateen1, Muhammad Noaman Yousaf2, Niamatullah Khan1,Faisal Nouman2, Waheed Iqbal1 and Sami Siraj1*
1Institute of Basic Medical Sciences, Khyber Medical University, Peshawar
2Mufti Mahmood Teaching Hospital, Dera Ismail Khan
Background: The combination therapy of Interferon and ribavirin remains the first line treatment in patients with chronic hepatitis C in Pakistan. Although the success rate of 24-week long treatment in treatment naïve patients’ genotype 3a hepatitis C patients is high, there are a few reports on retreatment of non-responder and relapse hepatitis C patients.This study was designed to assess the sustained virological response (SVR) rates in treatment-experienced patients, who had unfavorable outcome from their previous therapy.
Methodology: One hundred and thirty two (132) patients who had shown relapse (n=59) and non-response (n=73) to conventional IFN plus ribavirin were retreated with Pegylated IFN plus ribavirin. Outcomes at weak 12(early virological response [EVR]) and at week 24 (End of response [SVR]) were analyzed.
Results: One hundred and thirty two patients who had relapsed (n=59; 63%genotype3a) after previous conventional interferon plus ribavirin therapy or were nonresponders (n=73; 48% genotyp3a) were analyzed. Of the relapsers, 78% achieved an EVR and also the SVR. Of the non-responders, 81% achieved an EVR and also the SVR. SVR rates were 27% and 15% for genotype 3a and 2a respectively. EVR and low hepatitis C viral (HCV) RNA level on retreatment were associated with SVR. SVR rate for relapse and non-response patients was nearly equal.
Conclusion: Low baseline and at four weeks after start of therapy remain the most crucial predictors for treatment outcome in both relapse and non-responders. Viral genotype, on the other hand doesn’t seem to affect the therapy outcome significantly.
Key words: Chronic Hepatitis C; Pegylated Interferon plus ribavirin; Retreatment; Relapse; Nonresponders.
Address of corresponding author:
*Sami Siraj, PhD
Department of Pharmacology,
Institute of Basic Medical Sciences,
Khyber Medical University, Peshawar, Pakistan
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