Therapeutic Response to Pegylated Interferon ?-2a and Ribavirin in Genotype 4 Chronic Hepatitis C in Sub Saharan Africans - Abstract
Background
The association of Pegylated interferon (Peg-inf) and Ribavirin (RBV) remains the standard of care for the treatment of genotype 4 Chronic Hepatitis C
(CHC4) in sub Saharan Africa. Data on CHC4 in sub Saharan population are scarce.
Aim: To investigate the rate of Sustained Virological Response (SVR) in sub-Saharan patients treated with association of Peg-inf alpha 2a and ribavirin.
Methods:
• Patient selection: We included files of CHC4 Cameroonian patients aged 18 to 70 years, naive to previous interferon therapy. Patients should
present with an F2 fibrosis; or F1 with persistent high viral load or elevated ALT.
• Study design: It was a multicenter cohort study. All the files were reviewed by a therapeutic committee. Patients were given a weekly 180µg
subcutaneous Peg-inf and daily oral ribavirin. The duration of planned therapy was 48 weeks. The primary efficacy endpoint was the SVR. The
secondary endpoints were the different Virological Responses (VR) at set points, according to WHO. RNA levels were measured by Real time
TaqMan Roche PCR. Data were analyzed using the using ?2 and Fischer’s exact test accordingly.
Results: We included 74 female and 128 males patients, aged 42 to 69, for a mean of 53.6±8.2 years. Transmission risk factors were dominated by
scarifications piercing and tattoo. The majority of patients (55.4%) had severe fibrosis. The RVR was 16.8%; the EVR, 67.8%; the eRVR, 51.9%; the DVR,
19.2%; the ETR, 48% the partial response, 43.1%; and the SVR, 36.1%.The relapse rate was 24.7%
Conclusion: This first study in sub-Saharan populationsshows that the response to the association of Peg-inf to RBV as standard of care in CHC4 in black
African is poor. It confirms what has been observed in Afro Americans. There is a need to shift to new therapeutic protocols and readapt international guide
lines, by including the racial component.