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To determine the response rate to sofosbuvir and ribavirin in chronic Hepatitis C Virus (HCV) patients who did not respond or relapsed with interferon therapy. A case series study was performed at Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2017- January 2019. HCV RNA positive were initiated in eligible patients with sofosbuvir 400mg once daily and ribavirin 400mg orally according to body weight for six months. Rapid viral response (RVR) [normal/undetectable ALT and AST level or very low HCV RNA at 4-6 weeks]. HCVRNA, CP, ALT were checked after 3 months of stopping treatment to confirm sustained virologic response (SVR). Of 100 cases, 16 (16%) were non-responders while relapse was observed in 84 (84%) patients. Among the 13 cirrhosis patients, 11 (84.6%) achieved SVR. Females had a significantly higher response rate as compared to males (p value 0.034). The sustained virological response rate in interferon treated chronic hepatitis C patients retreated with sofosbuvir and ribavirin was found satisfactory. [ABSTRACT FROM AUTHOR]

Background: Interferon with ribavirin is the recommended treatment for chronic hepatitis C with a response rate ranging from 50-80% in different countries. Although sustained response is comparable to clinical cure, but whether interferon therapy slows down the disease process in non-responders and relapsers is not known. Objectives: To determine the long term outcome of chronic HCV patients who have completed the interferon therapy and compare results between responders, relapsers and non-responders. Patients and Methods: Retrospective case record analysis of chronic hepatitis C patients who were treated with conventional interferon and ribavirin for 6 months during 1998 to 2002 and their follow up till 2011 were included. Depending upon the response they were divided into three groups i.e. responders, non responders and relapsers. Results: A total of 175 patients were included. There were 126 (72%) males and 49 (28%) females, whose ages ranged from 11 to 70 years (mean 35.8 ± 10.3). After interferon therapy, 109 were sustained responders, 33 were relapsers and 33 non responders. Mean age of the responders (32.4 ± 8.8 years) was significantly less as compared to non responders (40.4 ± 12.0 years) and relapsers (42.4 ± 8.0 years), (p < 0.05). Responders had a much better follow up i.e four years as compared to non responders which was statistically significant (p <0.05). During 10 years follow up, cirrhosis developed in 3 (2.8%) sustained responders, 6 (18.2%) non responders and 8 (24.2%) relapsers. During yearly follow up, sustained responders had significantly lower mean ALT and AFP levels as compared to non responders and relapsers (p < 0.05) while non responders and relapsers had lower albumin levels as compared to the responders (p < 0.05). Conclusion: Majority of the sustained responders had disease eradication, but non responders and relapsers should be followed for any evidence of cirrhosis. [ABSTRACT FROM AUTHOR]

Treatment of chronic hepatitis C (HCV) is difficult in thalassemics due to the haemolytic side effects of therapy. This study evaluated the treatment response to conventional interferon and ribavirin in HCV patients with thalassemia major. It was conducted at PMRC Research Centre, Jinnah Postgraduate Medical Centre (JPMC) Karachi. At baseline complete blood count, liver function tests, serum protein/ albumin, random blood glucose, serum ferritin, TSH, HCV RNA (quantitative) and genotyping were done. Conventional interferon 3 MIU thrice weekly and ribavirin 400 mg daily was given for 24 or 48 weeks. HCV RNA was done at 1st month (RVR), 3rd month (EVR), 6th month (ETR) and six months post treatment sustained virological response (SVR). A total of 17 Anti HCV positive patients, age range 7-28 years were included.HCV RNA was found in 12. Treatment was completed in 8 patients. Genotype 3(87.5%) was found in 7 patients, 1 had genotype 1. RVR was achieved in 5 (62.5%) cases, negative PCR at 3 and 6 months of treatment (EVR) in 7 (87.5%) patients, one patient was non responder. SVR was achieved in 2(25%) patients. Anaemia was the most common side effect due to which transfusion requirements increased in 4(50%) patients.

Recommended treatment of chronic Hepatitis C virus (HCV) infection is interferon and ribavirin. Most patients develop side effects during treatment. Weight loss is one of the side effects of interferon therapy. Present study was conducted at Pakistan Medical and Research Centre (PMRC), Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 1998 - December 2010, to find out the frequency, extent of weight loss, its recovery after interferon therapy and the impact of weight loss on treatment response. Body weight was recorded on regular outpatient visits i.e initially, then at 1, 3 and 6 months of treatment and six months post treatment. Out of 260 patients, 176 (67.7%) observed statistically significant weight loss (p<0.05), on completion of therapy as compared to initial visit. Weight loss during interferon therapy was found to be independent of age, gender, treatment outcome, serum albumin, haemoglobin, white blood cell (WBC) and platelet count. Body weight returned to baseline within six months after completion of treatment in most cases.