Clinical

Egyptian HCV genotype often responds to interferon/ribavirin

Last Updated: 2009-08-25 13:28:44 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treatment with pegylated interferon alfa-2a plus ribavirin is effective in roughly two-thirds of patients infected with hepatitis C virus (HCV) genotype 4, French and Egyptian researchers report in the September issue of the Journal of Medical Virology.

Dr. Arnaud Fontanet of the Institut Pasteur in Paris and colleagues observe that HCV trials in Europe and North America have largely involved patients with genotypes 1, 2 and 3, whereas in Egypt, the predominant genotype is 4.

In 95 Egyptian patients with chronic HCV 4 infection who received combination therapy for 48 weeks, the overall sustained virologic response rate after 72 weeks of follow-up was 61.1%.

Sustained responses were seen only in patients who had 1-log reductions in viral load by week 8 of treatment or 2-log reductions by week 12.

Also, the authors report, the sustained response rate was higher in the 90% of patients who were adherent for the first 3 months, compared to those who were not (65% versus 22%).

Side effects were generally mild and well managed by dose reductions. Treatment interruption was required in only 2 patients.

The estimated sustained response rate of 60%, say the investigators, falls between the response rates of genotype 1 (42-26%) and genotypes 2 and 3 (76-82%).

Dr. Fontanet told Reuters Health, "Demonstrating locally the 60% efficacy of a combined pegylated interferon and ribavirin therapy on genotype 4 chronic hepatitis C allowed for the recent opening of sixteen HCV treatment centers in Egypt as part of the national treatment program."

J Med Virol 2009;81:1576-1583.