Baseline Predictors of Sustained Virological Response to Pegylated Interferon and Ribavirin in Egyptian Patients Infected with Viral Hepatitis C

Background: Egypt represents the highest prevalence of HCV worldwide. Identifying Predictive factors for response to antiviral therapy in patients with chronic hepatitis C virus (HCV) infection especially those with genotype 4 may provide information to optimize and/or individualize the treatment of HCV genotype 4 infected patients, thus improving antiviral response. Aim: To analyze the data from Egyptian chronically infected patients with HCV treated for 48 weeks with a course of Peg interferon alfa-2a and alpha-2b plus Ribavirin, to determine the baseline factors associated with SVR. Patients and Methods: Retrospective data of 3719 patients with chronic HCV who had received pegylated interferon/ Ribavirin therapy in the context of the national program at Cairo-Fatemia Hospital, Egypt were retrieved. Different baseline demographic, laboratory, histological [grade and stage (Metavir score)] and virological parameters were recorded before initiating treatment and response to treatment was evaluated by PCR at 12, 48 and 72 weeks of treatment. Results: The estimated sustained virological response (SVR) at week 72 was 54%. On doing Univariate and multivariate analysis of the base line factors related to SVR, the most significant factors detected for achievement of sustained virological response were male gender and the grade of inflammation (Grade 2, 3) at a p-value <0.01, <0.01 respectively and the most significant factors related to failure of SVR achievement were base line ALT >40u/1 at a p-value <0.05, as well as Viremia if >600x10 3 IU, baseline AFP >10ng/m1 and stage of fibrosis (F2, F3, F4,) with at p<0.01 respectively. Conclusion: Male gender, high grade of inflammation, were found to be significant factors in achievement of SVR, however, higher stages of fibrosis and higher level of viremia, ALT and AFP at base line were found to be the predictive factors that play a significant role in failure of achievement of sustained virological response to HCV.