COMPARATIVE EFFECTIVENESS AND ADVERSE EFFECTS OF INTERFERON ALPHA-2b PLUS RIBAVIRIN THERAPY IN HEPATITIS '˜C' FOR 26 WEEKS
Abstract
Background: Hepatitis C is major emerging challenge for pathologists and treating physicians allover the world. Already 10 million Pakistani population has become anti-HCV positive. It is not
only affecting hepatobiliary system but with passage of time research is revealing that Hepatitis C
is going to involve almost every organ of the body. With timely diagnosis and treatment, millions
of patients can be saved from morbidity and mortality. The nation has to sacrifice initial economic
allocations to avoid later millions of mortalities and greater economic losses on affected patients
and to support their families. The objective of this study was to evaluate effectiveness of combine
therapy of Hepatitis C in local population of Pakistan. Methods: This case series study was done
at CMH Okara, Kohat, Abbottabad, and PAF Hospital, Shorkot from August 2000 to August
2009. All 1,000 patients from 10 to 60 years of age, confirmed anti-HCV Positive by ELISA and
PCR Positive for HCV RNA, were subjected to Interferon alpha-2b and Ribavirin therapy for
similar period of time. Response and adverse affects were observed by clinical examination, blood
complete picture including platelet count and ALT fortnightly. PCR for HCV RNA and ultrasound
abdomen (hepatobilliary system) was done quarterly during treatment and 6 monthly for 2 years
after treatment to review the sustained response and relapse. Results: Over all cure rate after 2
years was 855 (85.5%) excluding the 50 (5%) of initial resistant to one year treatment and 95
(9.5%) re-treated relapse cases. One hundred and forty-five (14.5%) patients were found to be
resistant to treatment. Conclusion: Hepatitis C must be treated timely after proper diagnosis.
Interferon and Ribavirin combination have shown high '˜cure' rate in Hepatitis C. In spite of high
cure rate of 85.5% with timely and proper treatment, low socio-economic status is a major
problem for poor individuals to get treatment. Preventive aspect must be strictly followed and
implemented.
Keywords: HCV, Anti-HCV, PCR, ALT, ELISA, Interferon alpha-2b, Ribavirin, Adverse effects
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