Treatment effects of standard of care for chronic hepatitis C in real world: A personal experience of a hepatologist in a Medical Center in Southern Taiwan

In Taiwan, prevalence of chronic hepatitis C virus (HCV) infection was 4.4%. But it could be 24% to 90% in some endemic areas. Combination therapy of peginterferon alpha 2a/2b plus ribavirin is the current standard of care (SOC) for patients with chronic HCV (CHC). Objectives: From the viewpoint of General Medicine (GM) physicians, we should recognize that SOC for CHC patients was a therapy with high sustained virological response (SVR) rate and low withdraw rate. To elucidate the therapeutic benefit of SOC in real world, the experience for CHC treatment by a hepatologist was analyzed. From Jan 2005 to October 2009, 222 CHC patients underwent SOC by a hepatologist in a medical center in southern Taiwan were studied. Those who infected with genotypes other than genotype 1(G1) or genotype 2(G2) (n=12) or not tested for HCV RNA after end of treatment (n=8) were excluded. We enrolled 202 cases into analysis. Twelve (6%) patients quitted therapy for intolerable side effects. Among the 190 patients with completed treatment, 157 cases were naïve patients and 33 cases were retirement patients. The sustain virological response (SVR) rate was 56% and 88% for G1 and G2 naïve patients, and 48% and 100% for retreatment patients, respectively. This clinical observation showed that the SOC for CHC patients was effective method in real world. The General Medicine physicians should transfer CHC patients who meet criteria of SOC to hepatologist for decreasing the risk of development of liver cirrhosis and hepatocellular carcinoma in CHC patients.