Efficacy of interferon-based antiviral therapy in patients with chronic hepatitis C infected with genotype 5: A meta-analysis of two large prospective clinical trials

The characteristics and response rate to pegylated interferon and ribavirin (PEG‐INF + RBV) of patients with chronic hepatitis C infected with genotype 5 are poorly documented. A meta‐analysis of two large phase III/IV prospective randomized clinical trials conducted in Belgium in patients with chronic hepatitis C (n = 1,073 patients) was performed in order to compare the response to antiviral therapy of hepatitis C virus (HCV) genotype 5 with that of other HCV genotypes. A subset of HCV‐1 infected patients selected from within the study database were selected to match the HCV‐5 sample for known prognostic factors. In Belgium HCV‐5 is responsible for a significant minority of cases of chronic hepatitis C CHC (4.5%) and is characterized by a more advanced age (58.4 years), a high frequency of cirrhosis (27.7%), a specific mode of HCV acquisition, and a particular geographic origin (66.7% of patients from West Flanders). The primary comparative analysis showed that response to treatment with PEG‐INF + RBV of HCV‐5 is similar to HCV‐1 and lower compared to HCV‐2/3. The analysis of the matched patient subgroup demonstrates that the HCV‐5 “intrinsic sensitivity” to PEG‐IFN + RBV therapy is identical to HCV‐1, with a sustained virological response of 55% in both groups. In contrast to previous publications, this meta‐analysis suggests that HCV‐5 response to treatment is closer to HCV‐1 than to HCV‐2/3 and suggests that in Belgium HCV‐5 infection should be treated with the same antiviral regimen as HCV‐1. J. Med. Virol. 83:815–819, 2011. © 2011 Wiley‐Liss, Inc.