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New directions in hepatitis C treatment.

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Chronic Hepatitis C treatment is a rapidly changing arena. There are rapidly changing guidelines about the type of interferon use and duration of treatment. We are able to understand the disease process better after 20 years of research to improve the diagnostic tools and treatment type and duration.

There are new tools and parameters, both patient and doctors who are caring for these patients, need to understand. In 2010 viral kinetics is very important .It has to do with how the hepatitis C virus/human body response to introduction of Pegylated interferon .How quickly patient becomes HCVPCR negative. This is reflective of hepatitis C free i.e. no living virus in the body. If patient becomes HCVPCR negative after four Pegylated interferon injections, the chances are very high that particular individual will remain free of disease after completion of the treatment.

We did conducted a study in Pakistani patients with hepatitis C genotype3 treated with Pegylated interferon and Ribavirin who were HCV PCR negative after 4 weeks of treatment and its impact after the completion of treatment. 90% patients stayed free of virus after 1 year completion of treatment. This is very important development and provides a roadmap for treatment policy, patients who are not HCV PCR negative after 4 injections they need more than 6 months of treatment. The patients who become HCVPCR negative after 12 injections will need at least 9 to 12 months of therapy. This treatment plan will decrease the chances of recurrence of disease. In Pakistan we are facing a challenge of poor choice of injection and rather inappropriate duration of treatment.

This work will be presented in 45h (EASL) European association of study of liver diseases meeting being held in Vienna Austria from April 14th to April 18th…This study was conducted by young researchers Dr Uzma Adeeb and Dr Fatima Khattak, under the supervision of Professor Muzzaffar Gill at Maroof International Hospital and Islamabad Specialists Clinic.