Response to Combined Pegylated Interferon and Ribavirin among Patients with Chronic Hepatitis C in Upper Egypt

Background and Aim of the Study: Egypt has one of the highest prevalence of hepatitis C in the world. Combination therapy using pegylated interferon alfa 2a or alfa 2b plus ribavirin is now the established standard therapy for chronic hepatitis C. However, non-response to this therapy remains common and is associated with several factors. We aimed to assess the response rate and the factors affecting the response to pegylated interferon and ribavirin among patients with chronic hepatitis C in Upper Egypt.Patients and Methods: A clinical trial study was conducted in the center for treatment of chronic hepatitis C in Assiut Governorate included 400 patients with chronic HCV infection fulfilling the inclusion and exclusion criteria for treatment with pegylated interferon (PEG-INF) plus ribavirin. All the included patients were subjected to detailed medical history and complete clinical examination, detailed abdominal ultrasonogaphic examination, laboratory investigations including complete blood picture, complete liver function tests, blood sugar, serum creatinine, prothrombin time and INR, aFP, HBsAg, ANA, T3, T4, TSH, quantitative PCR for HCV-RNA, fundus examination, ECG and liver biopsy with grading and staging with METAVIR Score.Results: The responses to PEG-INF plus ribavirin at 12, 24, 48 weeks and SVR were 292/400 (73.0%), 289/400 (72.2%) and 257/400 (64.2%) and 96/233 (41.2%), respectively. The high pretreatment viral load is associated with poor response at 12 and 48 weeks of therapy and sustained virological response (SVR). The high pretreatment weight and body mass index (BMI) were associated with poor response at 12 weeks while high pretreatment AST and lower WBC count were associated with poor response at 24 weeks of therapy. Early virological response (at 12 weeks of therapy) can significantly predict the response at 24 and 48 weeks and SVR (p=0.000, p=0.03 and p=0.000, respectively).Conclusion: This study concluded that, SVR after combined PEG-INF plus ribavirin for patients with chronic HCV infection in Upper Egypt was 41.2%. The pretreatment viral load was the only significant predictor for SVR among those patients. Early virological response significantly predicted the response at 24, 48 weeks of therapy and SVR.