Treatment history: Factors that affect the outcome of hepatitis C virus treatment with interferon-alpha 2a/b and ribavirin

Abstract

Introduction. Until the 1990s, there was no available treatment for chronic hepatitis C, but during this decade the benefits of interferon-alfa therapy were reported. At the end of the 1990s, the pegylated interferon-alfa 2a/b has significantly altered the treatment, whereas direct acting antivirals have significantly affected the treatment. The aim of this study was to show the most significant predictive factors of therapy response among patients with chronic hepatitis C treated with pegylated interferon-alfa 2a/b and ribavirin. Material and Methods. A non-randomized retrospective study included 292 patients with chronic hepatitis C treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, from 2008 to 2015. Results. The study showed that therapeutic response was not affected by sex, serum viral load, or if the therapy was applied for the first time or repeated. A sustained virological response was statistically significantly more frequent in younger patients, as well as in patients without extrahepatic manifestations. Cases with higher progression of fibrosis were associated with lower chance for sustained virological response. Genotype 1 showed to be a predictor of adverse response to therapy, and genotype 3 as a predictor of sustained virological response. Steatosis was significantly less frequent in patients with genotype 1 with sustained virological response. Patients with a shorter duration of infection were more prone to sustained virological response. Conclusion. A positive response to pegylated interferon-alfa 2a/b and ribavirin was found in 70.20% of patients with chronic hepatitis C. Elderly age, late detection of the infection, hepatitis C virus 1 genotype, fibrosis progression, presence of hepatic steatosis, and extrahepatic manifestations were risk factors for poor treatment outcome.