Rukhsana Javed Farooqi

Conventional Interferon Alfa-2b and Ribavirin for 12 Versus 24 Weeks in HCV Genotype 2 or 3

OBJECTIVE To determine the efficacy of 12 weeks therapy with conventional interferon and ribavirin in chronic hepatitis C genotype 2 and 3 naive patients. STUDY DESIGN A randomized clinical trial. PLACE AND DURATION OF STUDY Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from January 2005 to October 2006. METHODOLOGY Two hundred and twenty seven patients with chronic hepatitis C genotype 2 or 3 naive patients were enrolled in the study. All the patients were started on conventional Interferon 3 MIU, S/C, three times a week plus Ribavirin 800 to 1200 mg in divided doses daily. HCV-RNA qualitative PCR was determined after 4 weeks. In case of undetected PCR, patients were randomized to Group-I (where antiviral therapy was given for 12 weeks, n=81) or Group-II (where antiviral therapy was given for 24 weeks, n=81). In case of detected PCR, patients were given 24 weeks antiviral therapy, n=65 (Group-III). HCV-RNA PCR was determined at the end of respective therapies and after 6 months later on. Efficacy was defined as number of patients who achieved Sustained Virological Response (SVR) i.e. HCV-RNA PCR remained undetected 6 months after the end of antiviral therapy. RESULTS SVR was achieved in 66 patients (81.48%) in Group-I, 64 patients (79.01%) in Group-II, and 49 patients (75.35%) in Group-III. SVR rate was better in genotype 2 than genotype 3 in all the three groups (p=0.031, OR = 1.52). CONCLUSION Conventional Interferon and Ribavirin combination therapy remains an effective therapy in chronic hepatitis genotype 2 and 3 naive patients in our region. Determination of HCV-RNA qualitative PCR at 4 weeks seems to be an important predictor of SVR and should be used to tailor antiviral therapy to 12 or 24 weeks.