Delayed Viral Response and its Predictors in Non Responder Chronic Hepatitis C Patients to Conventional Interferon and Ribavirin Therapy

Abstract

Objective: To determine delayed viral response and its influencing factors in non responders patients of chronic hepatitis C who were not taking any antiviral treatment 6 months after completion of their conventional interferon therapy. Study Design: Retrospective; Cohort Study  Place and Duration of Study: Department of Medicine, Gastroenterology and Hepatology, SIMS / Services Hospital, Lahore, from January, 2007 to December, 2010. Methodology: The medical record of non-responder patients of chronic hepatitis C to conventional interferon and ribavirin were retrospectively analyzed as well as their viral status was checked by Real Time Amplification method during 6 months to 2 years post-treatment. Non-compliant and incomplete follow-up cases were excluded. Factors influencing the post-treatment viral response were analyzed by bivariate analysis. Results: A total of 1175 patients received interferon therapy along with ribavirin; 700 were called, but only 314 came for follow up. Among 70 patients who were non responders to conventional interferon, 5 (7.14%) patients developed delayed response and 65 (92.86%) remained still non responders. Post-treatment delayed self clearance of virus was seen more in male gender, having age >40 years, body weight <70 Kg and normal ALT at the end of treatment. However, there was a statistically significant association between the body weight (OR=0.839, CI: 0.719-0.979, p=0.014) and delayed response of chronic hepatitis c virus. Result depicts that chance of delayed response among over weight non-responder patients decreases to 16.1%. Conclusion: Post treatment follow up for viral status in non responders patients of chronic hepatitis C can be beneficial in the form of delayed response and body weight <70 Kg is its best predictor.