Treatment Outcomes in the Management of Patients with Chronic Hepatitis C: Case Series of Faculty of Medicine Vajira Hospital, Navamindradhiraj University

Abstract

Objectives: To assess treatment outcomes of different treatment options in the management of patients with non-cirrhotic chronic hepatitis C (CHC) and hepatitis C virus-related compensated cirrhosis at Faculty of Medicine Vajira Hospital, Navamindradhiraj University

Methods: Retrospective study of 54 cases were diagnosed between 1989 and 2011. Forty-nine cases with sufficient data were enrolled into the study. Main outcome measured is efficacy of treatments, including sustained virological response (SVR), end-of-treatment response (ETR), virological relapse, progression to cirrhosis and progression to hepatocellular carcinoma. The adverse events of treatments were reported.

Results: The prevalence of CHC genotype included in the study was genotype 1 in approximately 46.6%. There was no difference in genotype allocation between pegylated interferon alfa-2a and alpha-2b groups. The number of patients that received pegylated interferon alfa-2b was higher than those received pegylated interferon alfa-2a (61.2% vs 36.7%). A higher proportion of patients who received pegylated interferon alfa-2b was observed in non-cirrhotic CHC group (64.9% vs 32.4%). In this study, 85.7% of patients (42/49) completed treatment course. Overall, 88.4% achieved end-of-treatment virological response. The result was not significantly different between cirrhotic and non-cirrhotic groups. End of treatment virological response was achieved in greater than 90% in those received pegylated interferon alfa-2a irrespective of cirrhotic stage. In this study, viral relapse was found in 8 patients (8/38, 21.05%) and most of relapsed cases (6/8, 75%) were associated with advance fibrosis or compensated cirrhosis. Patients completed the courses of treatment had significantly lower rate of disease progression to compensated cirrhosis (4.44% vs 28.57%, p < 0.05), and to hepatocellular carcinoma (2.74% vs 28.57%, p < 0.01).

Conclusion: Successful treatment outcomes were found in the management of chronic hepatitis C with the standard treatment of pegylated interferon alfa and ribavirin. This study provided useful information about treatment paradigms, treatment outcome and disease progression in the CHC patients in Vajira Hospital.