Pegylated interferon and ribavirin therapy for chronic hepatitis C virus genotype 4 infection

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Abstract
Hepatitis C Virus (HCV) is classified into six genotypes. Genotype 4 is now spreading in Europe, especially among drug users, who are often infected with both HCV and the human immunodeficiency virus (HIV). Previous studies have shown that HCV‐4 responds poorly to interferon. Pegylated interferon (peg‐IFN) associated with ribavirin is now the most effective treatment for eradicating the virus. We have now studied the response of HCV‐4 to peg‐IFN and ribavirin and investigated the influence of HIV infection on anti‐HCV therapy. Twenty‐eight patients infected with HCV‐4 were given peg‐IFN plus ribavirin for 48 weeks. Patients infected with HCV alone tended to have a better initial response (66%) than patients infected with both HCV and HIV (30%, P = 0.06) and eradication was better (50%) than in doubly infected patients (15%, P = 0.06). After controlling for major factors influencing virus response, the virus response 12 weeks after the beginning of treatment in patients infected with HCV‐4 (50%) was similar to that of patients infected with genotype 1 (53%) and lower than that of patients infected with genotypes 2 or 3 (82%, P < 0.05). The response 24 weeks after the end of therapy in patients infected with HCV‐4 (32%) was similar to that of patients infected with HCV‐1 (28%) and lower than that of patients with HCV‐2 or HCV‐3 (62% P < 0.05). These results indicate that HCV‐4 patients should be considered to be difficult‐to‐treat. J. Med. Virol. 77:66–69, 2005.