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Pegylated interferon‐alpha 2b–ribavirin combination in Egyptian patients with genotype 4 chronic hepatitis

2005; Wiley; Volume: 12; Issue: 4 Linguagem: Inglês

10.1111/j.1365-2893.2005.00604.x

1365-2893

M. Derbala, A. M. Amer, Abdülbari Bener, A. C. Lopez, Mahmoud Omar, M. El Ghannam,

Liver Disease Diagnosis and Treatment

Summary. Egypt has a high prevalence rate of hepatitis C (HCV) infection and as much as 90% is genotype 4. Response to interferon (IFN) varies with viral genotype and degree of fibrosis. Genotype 4 is poorly sensitive to standard IFN and IFN–ribavirin combination. We evaluated pegylated interferon (PEG‐IFN)‐ α 2b in our patients. Sixty‐one patients with compensated chronic HCV genotype 4 were enrolled in two groups: group A (31 patients) received IFN‐ α 2b 3 MU three times per week and group B (30 patients) received 1.5 μ g/kg PEG‐IFN‐ α 2b once weekly. Ribavirin was added to each regimen in a dose of 800–1200 mg based on body weight. Patients were followed up for 24 weeks to assess the sustained response (SR). End‐of‐treatment response (ETR) was achieved in 11 of 31 patients (35.48%) in group A, and 13 of 30 patients (43.33%) in group B ( P < 0.05). Only eight patients in group A and 10 in group (B) achieved a sustained virological response (25.8 and 33.3%, respectively) ( P < 0.05). By computing ETR, SR or relapse and pretreatment baseline data (pretreatment, viral load, alanine transaminases, necroinflammatory and hepatic fibrosis), both inter‐ and intragroup, no significant correlations could be detected. In terms of safety and tolerability, PEG‐IFN‐ α 2b and IFN‐ α 2b were comparable. In spite of mild insignificant increase in ETR and SR with the pegylated form, the poor response of genotype 4 in Egypt (genotype 4a) to different forms of IFNs may be related to an intrinsic resistance to the direct antiviral effect of IFN.