A randomized trial of 24 versus 48 weeks of peginterferon alpha-2a plus ribavirin in Egyptian patients with hepatitis C virus genotype 4 and rapid viral response.

BACKGROUND AND AIM: Little data is available regarding the 24-week therapy with pegylated interferon and ribavirin in Egyptian patients with hepatitis C virus (HCV) genotype 4 infection. We aimed to investigate the efficacy of 24-week versus 48-week peginterferon alpha-2a plus ribavirin therapy in patients with HCV genotype 4 infection with with rapid virological response.

METHODS: This trial included 102 patients with HCV genotype 4 infection and low viral load. They were treated with peginterferon alpha-2a (180 microg/week) plus ribavirin. Patients (87/102) with a rapid virological response were randomized for a total treatment duration of 24 weeks (group A: 43) or 48 weeks (group B:44). Virological responses (EVR: early virological response, EOTR: end of treatment response, and SVR: sustained virological response) were assessed for each group.

RESULTS: In group A, EVR was achieved in 37/43 (84%) patients, while EOTR was achieved in 34/43 (79%) patients and SVR in 30/43 (70%) patients. In group B, on the other hand EVR was achieved in 38/44 (84%) patients, while EOTR was achieved in 35/44 (80%) patients and SVR in 32/44 (73%) patients. No significant difference in SVR rates was observed between the two groups. The rate of adverse events was higher in group B, with lower adherence rates than group A.

CONCLUSIONS: In patients with chronic HCV genotype 4 infection with rapid virological response and low viral loads, a 24-week peginterferon alpha-2a plus ribavirin therapy is as effective as a 48-week therapy with lower rate of adverse events.