Efficacy of Treating Chronic Hepatitis C Genotype 3 Infection with Peginterferon Alfa plus Ribavirin in Real-world Practice
Apichet Sirinawasatien MD*; Thanaya Techasirioangkun RN*
Affiliation : * Division of Gastroenterology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background : Chronic hepatitis C genotype 3 is a major public health problem worldwide. Standard treatment with peginterferon
alfa plus ribavirin for 24 weeks is a recommended treatment in settings in which direct-acting antiviral agents are not
available.
Objective : To evaluate the treatment efficacy in Thailand of peginterferon alfa combined with a ribavirin treatment regimen,
and to evaluate parameters predicting treatment response.
Material and Method: Data were retrospectively retrieved of consecutive chronic hepatitis C genotype 3 patients who were
treated with peginterferon alfa plus ribavirin for 24 weeks at Rajavithi Hospital, Bangkok, between 1st January 2013 and 31st
December 2016. Clinical characteristics, compliance with treatment and laboratory data were reviewed. Sustained virological
response (SVR) and predictors of treatment response were analyzed.
Results : A total of 119 patients completed treatment. Most were aged 40 years or more, and males accounted for 66.4%. Fifty-
four percent of patients had BMI of more than 23 kg/m2, and half of them had cirrhosis, which was defined as liver stiffness
equal to or more than 12.5 kPa, and 97% of these had Child Class A while the remaining 3% had Child Class B. Baseline
HCV RNA was less than 400,000 IU/mL in 42.9% of cases and equal to or more than 400,000 IU/mL in the other 57.1%.
Overall 69.7% of patients achieved SVR, while 30.3% were non-responsive. Multivariate analysis revealed that liver stiffness
of less than 12.5 kPa and compliance with the 80/80/80 adherence rule were associated with SVR with odds ratios of 6.50
(2.24 to 18.83) and 4.76 (1.64 to 13.82), respectively.
Conclusion : The efficacy of a standard treatment with peginterferon alfa plus ribavirin for chronic hepatitis C genotype 3
patients is satisfactory in real-world practice. Sustained virological response can be improved by selecting patients who are
non-cirrhotic for treatment with this regimen and making them aware of the importance of complying with the 80/80/80
adherence rule.
Keywords : Chronic hepatitis C, Genotype 3, Treatment, Peginterferon alfa, Ribavirin, Sustained virological response
