Treatment Outcomes and Costs of Pegylated Interferon and Ribavirin Therapy in Chronic Hepatitis C Virus Infection
Wattana Sukeepaisarnjaroen MD1,2, Tanita Suttichaimongkol MD1, Kittisak Sawanyawisuth MD, PhD1,3, Udomlack Peansukwech MSc1, Vilai Sarapanitch RN4, Pingpan Duangrat RN5
Affiliation : 1 Department of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Liver Disease Research Group, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 3 Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, and Research and Training Center for Enhancing Quality of Life of Working Age People, Khon Kaen University, Khon Kaen, Thailand 4 Clinic of Medicine, Outpatient clinic, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 5 Privacy Clinic, Outpatient clinic, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : Hepatitis C virus [HCV] infection is a common infection in Thailand and Asian Pacific countries. In Thailand, a
regimen of pegylated interferon plus ribavirin has been accepted for HCV treatment since April 2015. Recently, some
guidelines do not recommend this regimen for HCV infection. This study aimed to evaluate the efficacy and cost of treatment
by this regimen.
Materials and Methods : The study was a prospective study conducted at Khon Kaen University. The inclusion criteria were
adult patients’ age between 18 and 65 years with chronic HCV infection, had significant fibrosis (Metavir fibrosis score >F2),
and treated with pegylated interferon plus ribavirin for 24 or 48 weeks depending on their genotype. Treatment outcomes
and costs were analyzed by evidence of sustained virological response [SVR].
Results : There were 185 patients met the study criteria. There were 18 patients (29.0%) with genotype 1, who were unable
to complete the treatment. The average SVR rate was 64.3%; genotype 3 (71.8%) and genotype 1 (50.0%). The total costs
for all patients were 25,215,607 baht (US$752,705). Of those, 8,090,037 baht (US$ 241,494, 35.7%) were used for non-SVR
group, particularly those patients with genotype 1.
Conclusion : Pegylated interferon plus ribavirin in chronic HCV patients with significant fibrosis had variable SVR outcomes.
Genotype 1 and 3 HCV had fair outcomes due to drug intolerability or low SVR rate. Approximately one-third of the total
budgets were lost for the non-SVR group.
Keywords : Chronic hepatitis C, Peg-interferon, Ribavirin, Sustained virological response, Intolerability, Cost
