Outcome of combined interferon-ribavirin in the treatment of chronic hepatitis C.

OBJECTIVE: To determine the outcome of 24 weeks combination treatment with Interferon and Ribavirin as initial therapy in chronic hepatitis C patients and frequency of associated adverse effects during the treatment.
DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Medical Unit, DHQ Hospital, Daggar, District Buner, NWFP, Pakistan, from January 1999 to June 2002. PATIENTS AND METHODS: Three hundreds and fifty consecutive non-cirrhotic, chronic hepatitis C patients with positive HCV anti bodies by 3rd generation ELISA, positive HCV RNA by polymerase chain reaction (PCR) and raised serum alanine amino transferase (ALT) were evaluated and treated with combination of interferon alfa 2-b three million units subcutaneously three injection weekly and ribavirin 800-1200 mg orally daily for 24 weeks and followed for another 6 months. The HCV RNA was checked after 12 weeks and at the end of the treatment. The ALT level was checked after 04 weeks, at 12 weeks, and at the end of the treatment. End of the treatment viral response, sustained viral response and side effects of therapy were noted.
RESULTS: Normal ALT was observed in 260 (74.2%) of the patients after one month of treatment and 310 (88.5%) of the patients at the end of 03 months. HCR RNA was not detectable in 275 (78.5%) of the patients at the end of 03 months (12 weeks of treatment). At the end of 24 weeks of treatment the HCV RNA was not detectable in 298 (85.14%) patients. Two hundred and seventy-six (78.85%) of the patients had persistently normal ALT and HCV RNA in the six months' follow up after treatment.
CONCLUSION: Combination treatment of interferon and ribavirin for 24 weeks produced 88.57% biochemical and 85.14% virological response. The side effects of anti-viral therapy were tolerable and manageable.