Predictors of response to antiviral therapy in patients with chronic hepatitis C from Pakistani population

Background Hepatitis C virus (HCV) constitutes a major public health issue around the world, especially in developing countries like Pakistan. In this study, we assessed outcome of interferon (INF) treatment in chronic hepatitis C patients categorized by gender, age, and viral load.Methods In this study, 750 HCV positive patients with genotype 3 were selected, out of which 616 completed the entire treatment. Their personal history, pro-treatment HCV RNA and serum alanine transaminase (ALT) was quantified.Patients were treated with combination therapy of INF-α 2b three million units (thrice a week) plus ribavirin (1000-1200mg per day) for 24 weeks. After 24 weeks their HCV RNA and serum ALT level was quantified.Results Out of the 616 patients, 391 (63.5%) responded to therapeutic regimen (INF-α 2b plus ribavirin). Among the responders, 27.1% were men and 36.4% were women. Best treatment response was observed in patients having Iow viral load ＜8×105 IU/ml and age ≤40 years than patients having Iow viral load and age ＞40 years (73.2% vs. 60.3%, P=0.05).Conclusions Better response to IFN-α 2b plus ribavirin was observed in patients with lower viral RNA and younger age.It suggests that all patients considered for treatment should have quantification of serum HCV RNA level. The result can be used to counsel patients on the likelihood of response and may influence the patient's decision on treatment.