Aim of the study is to establish the efficacy of treatment of chronic hepatitis C with interferon alpha-2b and ribavirin in treatment-naive patients, in non-responders to interferon monotherapy, in relapsers after interferon monotherapy, and to evaluate the possible predictors of treatment response.
Material and methods: One hundred thirty one patients with chronic hepatitis C were included and assigned to 24-week course of interferon alpha-2b with ribavirin. At the end of 24-week combination therapy biochemical, histological, virological and complete end-of-treatment responses were evaluated. Patients with virological end-of-treatment response were treated with interferon alpha-2b and ribavirin for further 24 weeks and followed-up for the next 6 months after stopping therapy.
Results: End-of-treatment response was assessed in 119 patients: 57.1% were treatment-naive, 28.6% were non-responders, and 14.3%--relapsers. Overall virological end-of-treatment response rate was 35.3%, biochemical--64.7%, histological--80.9% and complete--33.3%. Treatment-naive patients have better end-of-treatment response than non-naive patients in all dimensions, but statistical significance is reached only evaluating histological end-of-treatment response. Sustained virological response of overall 119 patients was in 23.6%. There was no statistically significant difference in sustained virological response rate among all patient groups. None of pre-treatment demographic, clinical, biochemical and morphological parameters was found as possible response predicting factors. Hepatitis C virus genotype was assessed in 40 patients. Hepatitis C virus genotype 1 was found in 34 (85%), genotype 2 in 3 (7.5%), and genotype 3 in 3 (7.5%) patients. In conclusion, in our studied population with high prevalence of hepatitis C virus genotype 1 (85%), there is low sustained virological response rate (23.6%) to interferon alpha-2b in combination with ribavirin therapy.