Treatment of chronic hepatitis C virus infection: the end of an era

Treatment of chronic hepatitis C genotype IV with interferon-ribavirin combination in Saudi Arabia: a multicentre study

Between 1996 and 1997, we conducted a multicentre study to assess the effect of combination therapy of interferon (IFN) + ribavirin on chronic hepatitis C genotype 4. Ninety-seven patients were enrolled. Sixty-eight patients (47 male and 21 female) were non-responders to previous therapy with IFN (Group I). Twenty-nine patients (19 male and 10 female) were new (Group II). Following treatment with IFN, 23% in Group I and 9% in Group II had a sustained biochemical response. Only 12% in Group I and 5% in Group II achieved a sustained virological response. Virus load was found to be the major factor determining response, followed by histology grading and staging. Like HCV genotype 1, HCV genotype 4 seems to have a poor response to therapy.

Pathophysiology and Treatment of Hepatitis C Infection

The pathophysiology and treatment of hepatitis C infection, formerly known as non-A, non-B hepatitis, are discussed. The worldwide prevalence is approximately 1%. The majority of patients infected with hepatitis C virus will develop chronic infection, leading to cirrhosis in a significant percentage. Transmission of hepatitis C is primarily through parenteral routes. Those who use intravenous drugs or received blood transfusions prior to 1992 comprise the major risk groups for the infection. The progression of chronic hepatitis C infection is insidious with possible progression to an inflammatory hepatitis developing within 5–10 years, cirrhosis in 10–20 years, and hepatocellular carcinoma in 20–30 years. Combination therapy with interferon alpha-2b and ribavirin is currently the treatment of choice. Therapy for hepatitis C continues to evolve with newer forms of interferon and HCV antivirals under development.