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The natural history and long‐term outcomes in patients with chronic hepatitis C genotype 4 after interferon‐based therapy
Author(s) -
Alfaleh Faleh Z.,
Alswat Khalid,
Helmy Ahmed,
Alhamoudi Waleed,
Elsharkawy Mohamed,
Omar Mohanned,
Shalaby Ahmed,
Bedewi Mohaned A.,
Hadad Qais,
Ali Safiyya M.,
Alfaleh Ahmad,
Abdo Ayman A.
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12127
Subject(s) - natural history , medicine , chronic hepatitis , genotype , interferon , term (time) , hepatitis c , immunology , virology , biology , gene , virus , genetics , physics , quantum mechanics
Background & Aims Hepatitis C virus ( HCV ) genotype 4 (G4) infection is common in the Middle East. Post‐treatment long‐term outcomes have not been reported in these patients. This study evaluates these outcomes in patients after interferon‐based therapy. Patients and methods A total of 157 patients were followed from June 2001 to February 2012. Descriptive and analytical statistics, cumulative outcomes and the independent predictors of disease progression were calculated. Results The overall age was 48.0 ± 11.8 years, 75 (47.8%) were males and 53 (70.7%) of 75 who were genotyped had G4. The follow‐up period was 63.8 ± 32.8 months. Sustained virological response ( SVR ) was achieved in 62 (39.5%) and 24 (45.3%) patients in the whole group and the G4 subgroup respectively. Among the whole cohort and the G4 subgroup, disease progressed in 59 (37.6%) and 21 (39.6%), respectively, with less progression in the SVR groups; 15/62 (24.2%) and 3/24 (12.5%) compared with non‐responders; 44 (46.3%) and 18 (62.1%) with P = 0.01 and 0.001 respectively. Multivariate logistic regression analysis showed that having diabetes mellitus ( P = 0.03), higher baseline APRI score ( P = 0.00) and non‐ SVR ( P = 0.00) were independent predictors of disease progression. G4 patients showed similar results, but ‘non‐ SVR ’ ( P = 0.00) was the only independent predictor of progression. Eight patients died and four developed HCC all among the non‐ SVR group only. Conclusions This study describes, for the first time, the natural history and demonstrates the beneficial long‐term effects of interferon‐based therapy in HCV G4 patients.