Predictors of Complete Early Virological Response to Pegylated Interferon and Ribavirin in Egyptian Patients with Chronic Hepatitis C Genotype 4

Purpose: To assess the efficacy and predictors of treatment response of chronic hepatitis C genotype 4 Egyptian patients with sofosbuvir and daclatasvir, with or without ribavirin.Methods: This prospective study enrolled 200 patients with chronic hepatitis C virus (HCV) genotype 4 infection who received sofosbuvir plus daclatasvir for 12 weeks, with the addition of ribavirin for treating cirrhotic patients. Immunological parameters such as natural killer (NK) cell percentage, phenotype, and serum C-X-C motif chemokine 10 (CXCL10) were evaluated prior to treatment and at the end of the treatment.Results: Overall, 92.5 % of the patients achieved sustained virological response at 12 weeks (SVR12), where the non-cirrhotic group had 96.29 % SVR12, while the cirrhotic group had 84.61 % SVR12. Nonresponders had lower pretreatment platelet count, higher CXCL10 levels, and lower baseline frequencies of NK cells and NK subgroup CD56- CD16+.Conclusion: Based on these results, the use of sofosbuvir plus daclatasvir with or without ribavirin for 12 weeks, is an effective regimen in the treatment of Egyptian patients infected with genotype 4 HCV. The predictors of non-response are advanced age, liver cirrhosis, lower pretreatment platelet count, higher level of CXCL10, lower baseline NK cells frequency and percentage of the dysfunctional subset CD56- CD16+. Keywords: Hepatitis C virus, Genotype 4, Sofosbuvir, Daclatasvir, Sustained virological response

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GAMMA GLUTAMYLTRANSFERASE IMPACT IN THERAPEUTIC RESPONSE OF CHRONIC HEPATITIS C: a systematic review of the literature

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032015000300016 ◽

2015 ◽

Vol 52 (3) ◽

pp. 239-246

Author(s):

Maria de Lourdes Albuquerque de QUEIROGA ◽

Raymundo PARANÁ ◽

José Eymard Moraes de MEDEIROS FILHO ◽

Giovannini Cesar A FIGUEIREDO ◽

Ananda Peixoto de ARAÚJO ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Virological Response ◽

Sustained Virologic Response ◽

Pegylated Interferon ◽

Virologic Response ◽

Early Virological Response ◽

Gamma Glutamyltransferase ◽

Interferon Α2a

BackgroundThe standard treatment of chronic hepatitis C is the administration of pegylated interferon α2a or α2b in combination with ribavirin, but adverse effects can be observed, as well as the high cost of this therapy. Therefore, there is interest in understanding the predictors of sustained virologic response, as the gamma glutamyltransferase.ObjectiveTo evaluate the serum levels of gamma glutamyltransferase as a predictor of response to treatment with pegylated interferon α and ribavirin in chronic hepatitis C.MethodsThis is a systematic review of literature, conducted by consulting PUBMED, LILACS, MEDLINE, SCOPUS, Cochrane electronic databases, and active search of articles selected between January 2000 and April 2013.ResultsA total of 4,785 titles were iden tified. Out of those material, following inclusion and exclusion criteria, 273 abstracts were selected, by two independent researchers. After reading those texts, the reviewers consensually included ten studies for systematization and classification, according to the criteria of the Oxford Scale. 1B studies are predominant (prospective cohort study - six studies). Rapid virologic response and early virological response were considered as estimates for the sustained virological response. The frequency of virologic response was identified in three studies and early virological response in two, with a total of 392 and 413 patients, respectively; sustained virologic response was reported in nine articles corresponding to 3,787 patients (76.5 %).ConclusionGamma glutamyltransferase is a predictor of sustained virologic response in the treatment of chronic hepatitis C with pegylated interferon α2a or α2b associated with ribavirin.

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Efficacy and Safety of a Novel Pegylated Interferon Alpha-2a in Egyptian Patients with Genotype 4 Chronic Hepatitis C

Canadian Journal of Gastroenterology ◽

10.1155/2010/717845 ◽

2010 ◽

Vol 24 (10) ◽

pp. 597-602 ◽

Cited By ~ 15

Author(s):

Alaa Awad Taha ◽

Ahmad El-Ray ◽

Maged El-Ghannam ◽

Bahaa Mounir

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Fibrosis ◽

Interferon Alpha ◽

Virological Response ◽

Pegylated Interferon ◽

Efficacy And Safety ◽

Genotype 4 ◽

Pegylated Interferon Alpha ◽

Egyptian Patients

BACKGROUND: Hepatitis C virus (HCV) genotype 4 is a common infection in Egypt and is the leading cause of liver disease.OBJECTIVE: To study the efficacy and safety of a novel 20 kD pegylated interferon alpha-2a derived fromHansenula polymorphain combination with ribavirin for the treatment of Egyptian patients with genotype 4 chronic hepatitis C (CHC).METHODS: One hundred seven patients with genotype 4 CHC were involved in the present study. Liver biopsy was performed in all patients. All patients received a fixed weekly dose of 160 μg of a novel pegylated interferon in combination with ribavirin in standard and adjusted doses. Serum HCV RNA levels were assessed by a real-time sensitive polymerase chain reaction assay at four, 12, 48 and 72 weeks after the start of therapy. Patients demonstrating an early virological response (EVR) completed a 48-week course of treatment.RESULTS: The overall sustained virological response (SVR) was 60.7%. The SVR in patients with a rapid virological response was significantly higher (91.7%) than in patients with complete EVR (67.74%) (P=0.033) and partial EVR (56.14%) (P=0.003). SVR was also significantly higher in patients with a low degree of liver fibrosis according to Metavir score (F1 and F2) (67.57%) compared with those with a high degree of liver fibrosis (F3 and F4) (45.45%) (P=0.017). The baseline viral load had no impact on SVR in the present series nor were any serious adverse events reported.CONCLUSION: The novel pegylated interferon alpha-2a assessed in the present study was effective for the treatment of patients with genotype 4 CHC, and was safe and well tolerated.

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