A local experience of treatment response in chronic hepatitis C infection

Hepatitis C virus infection is the major cause of liver cirrhosis. Antiviral treatment can achieve persistent viral clearance to prevent long-term complications of the disease. Despite the introduction of direct acting antivirals (DAAs) as effective therapy in recent years, the standard regimen consisting of interferon and ribavirin which are more accessible and inexpensive is still widely prescribed for the majority of worldwide hepatitis C patients in developing countries. The present study was conducted to demonstrate a local experience of treatment response (with combination therapy; interferon and ribavirin) and outcome in patients with chronic hepatitis C infection. In all, 107 patients from a referral centre for infectious diseases participated in the study from 2007 to 2012. They were evaluated for demographic characteristics, the disease, the presence of metabolic syndrome and its sub-scores, and lab characteristics. The resulting data were analysed with paired T-test, chi-square test, Fisher exact test and logistic regression, according to relevance. The virus eradication rate was 72.9% and 72% at the end of treatment and 6 months later, respectively. Of the patients with HCV chronic hepatitis, 27.96% had concomitant metabolic syndrome. There were statistically significant relationships between response to the treatment and the patient's age and gender, the genotype of the virus, presence of metabolic syndrome, waist circumference, BMI, viral load prior to the treatment and blood pressure (systolic and diastolic). Presence of metabolic syndrome (OR: 20.69, CI: 2.83-151.34, P=0.003) and the genotype of the virus (OR: 6.64, CI: (1.48-29.72), P=0.013) were independent risk factors of failure to achieve sustained virologic response in treatment of chronic hepatitis C with interferon and ribavirin in multivariate logistic regression analysis. According to the current study, HCV infection should be considered a metabolic disease, further to a viral infection. Metabolic factors may impact outcome of the antiviral therapy. Patients should be evaluated for metabolic factors prior to and during antiviral treatment.