Evaluation of Chronic Hepatitis C Patients from Different Aspects Before the Use of Direct Acting Antivirals

Objective: Chronic hepatitis C (CHC) virus infection is one of the leading causes of chronic liver disease in all over the world. The prevalence of CHC is almost 0.5-1% in Turkey. Until recently, pegylated-interferon (PEG IFN) alpha in combination with ribavirin was the main treatment of CHC. The aim of the study was to evaluate the real life data of CHC patients. Materials and Methods: We retrospectively evaluated the demographical data and treatment responses of patients with CHC who were followed and treated in our clinic between January 2008 and December 2015. Results: A total of 117 patients (67 female and 50 male) with a mean age of 48 (15-65) were included in the study. 105 patients were genotype 1, 3 were genotype 2 and 9 were with genotype 3. The patients were treated with PEG IFN alpha-2a (81/117) or alpha-2b (36/117) combined with ribavirin. We observed sustained virologic response (SVR) in 68% of all genotype 1 patients. While relapse was observed in only 1 patient among those with genotype 2 and 3, SVR was achieved in 11. The rate of SVR was only 42% among patients older than 60 years of age, whereas SVR was achieved in all young patients (range: 15-30). The overall SVR rate was 70%. Conclusion: As CHC can result in long-term complications (cirrhosis, terminal liver failure and hepatocellular carcinoma), patients without therapy remain at risk of developing progressive liver disease. Since advanced fibrosis is a predictor for poor prognosis and insufficient therapy outcome, early treatment is required to efficiently cope with this health problem, Although the rates of SVR with direct acting antivirals are very high, starting treatment in early stage could reduce the complications of CHC and transmission of the disease.