Evaluation of Early Virologic Response Rate to Peginterferon plus Ribavirin Combination Therapy in Hereditary Coagulation Disorder Patients with Chronic Hepatitis

The hereditary coagulation disorder patients are excessively at risk for hepatitis C virus (HCV) due to multiple blood and coagulation factors transfusions. Hepatitis C treatment was first based on the use of interferon alpha but later combination therapy with peginterferon plus ribavirin increased the sustained virologic response to 50%. The present study aimed to evaluate the response rate to treatment with peginterferon plus ribavirin in hereditary coagulative disorder patients with chronic hepatitis C. This study is a descriptive analytical and applied study without control group. Forty HCV positive hereditary coagulative disorder patients referred to our clinic during 2007-2008 were enrolled. Liver biopsy was not performed in any of the studied patients due to its potential risks. Treatment included peginterferon alpha-2a (180 mg/week) plus ribavirin (800-1200 mg/day) for 24-48 weeks. Early virologic response (EVR) was defined as a negative HCV-RNA level at the end of 12 weeks of treatment. In 12.9% of the patients, a positive history of previous treatment for hepatitis C with interferon and ribavirin was found. Virus genotype was 1b in 21.9% of patients, 1a in 37.5% and 3a in 34.4% and a combination of 3a and 1a in 6.3%. The mean pretreatment viral load was 1220183.7 copies/mL and viral load after 3-month treatment was zero (P<0.001). Among EVR enhancing factors (low virus level and young age of the patients), the young age was an important factor leading to full EVR achievement. Lack of severe complications and appropriate drug response excluding the viral genotype is indicative of the advantages of combination therapy of peginterferon plus ribavirin in hereditary coagulative disorder patients with chronic hepatitis C.