Pegylated vs. Standard Interferon in Combination with Ribavirin for Genotype 2 and 3 in Chronic Hepatitis C: 10 Years Experience in Local Population

Abstract

Objective:  To compare the response in patients of chronic hepatitis C of genotype 2 and 3 to standard interferon (IFN) plus ribavirin vs. Pegylated interferon plus ribavirin.

Type of Study:  Cohort type of case series.

Setting:  Study was based on 10 years data of patients of hepatitis C treated at Garden Clinic Lahore.

Patients and Methods:  Patients of chronic hepatitis C of genotype 2 and 3 were included and treated with either standard IFN plus ribavirin or peg IFN plus riba-virin for 6 months. Response to therapy was evaluated with qualitative PCR for end of treatment response (ETR) and sustained viral response (SVR). Both gro-ups of patients were compared using chi square test.

Results:  Total of 609 patients with mean age 39.8 (± 9.37) and male to female ratio 1.67 / 1 (381 / 228) were included. Genotype 3 was seen in 587 (96.4%) patients and genotype 2 in 22 (3.6%). Peg IFN plus ribavirin was given to 51 (8.4%) while 558 (91.6%) patients were treated with standard IFN and ribavirin. Biochemical response was noted in 462 (75.9%) while ETR was seen in 514(84.4%) patients. Relapse was noted in 99 (16.3%) patients, while PCR was negative both at end of treatment and 6 months later in 415 (68.7%) of them. Of patients with positive PCR at end of treatment, 38 had negative PCR 6 months later, while 57 still had positive PCR result. Overall sustai-ned viral response (SVR) was 74.4% (453 / 609). SVR in patients receiving peg IFN was 90.19% (46 / 51) which was significantly better (p value 0.007) than 72.93% (407 / 558), for standard IFN and ribavirin.

Conclusion:  Pegylated IFN plus ribavirin had better response in patients of chronic hepatitis C with geno-type 2 and 3 as compared to standard IFN plus riba-virin.

Key Words:  Chronic hepatitis C, Genotype 2 and 3, Pegylated interferon, Standard interferon, Sustained viral response.