Pretreatment Factors Predicting Sustained Virological Response to Pegylated Interferon/Ribavirin Combination Therapy in Egyptian Patients with Hepatitis C Virus Genotype 4

Background: Hepatitis C virus (HCV) is a growing health problem worldwide. Egypt has the highest HCV prevalence in the world. In the last decade, HCV-related morbidity doubled, and HCC related to HCV increased almost threefold. The desired goal with combination antiviral therapy is to obtain a sustained virologic response (SVR). The predictors of SVR of genotype-4 are not well represented because most of the data were on genotype-1; therefore, there is a need for further studies. Aim: To clarify the predictors of SVR to combination therapy in patients with HCV infection genotype-4 before initiating treatment. Patients and Methods: This retrospective study included 530 HCV patients treated with combination therapy pegylated interferon plus ribavirin. The patients were divided into two groups: SVR patients (Group I) and Non-SVR patients (Group II). Results: A significantly higher age was found in group II when compared with group I (P=0.0008). Also, a significantly higher pretreatment ALT, AST, alkaline phosphatase and HCV-RNA viral load levels were found in group II when compared with group I (P< 0.0001) for all. Patients with (age >40 years, pretreatment ALT level >2 folds, bilharziasis history, late fibrosis stages and late activity stages) were prone to be non-SVR than the others. Conclusion: Patients with (age >40 years, pretreatment ALT level >2 folds, bilharziasis history, late fibrosis stages and late activity stages) were prone to be non-SVR than the others. These findings may have important prognostic, cost saving and therapeutic implications in HCV patients treatment.