Therapeutic Response of Black Africans in the Treatment of Genotype 2 Chronic Viral Hepatitis c by Pegylated Interferon-ribavirin

Background: Although genotype 2chronic hepatitis C (CHC2) is usually credited with very good responses, data from sub Saharan Africans are poorly documented. Aim: To characterize the response to Pegylated interferon alpha 2a, and ribavirin in the sub-Sahara. Methods: Patient Selection: We consecutively included consented CHC2 treatment-naÏve adults from all treatment centers in Cameroon. Eligible patients, free from any other chronic liver disease or HIV infection, were required to have a serum viral load of at least 2000 copies HCV RNA/mL, and a level of fibrosis of F2 or higher. Study design: The medical records of patients who sought treatment were systematically reviewed by a committee. Efficacy was assessed by rapid virological response (RVR); early virological response (EVR); end of treatment response (ETR); and sustained virological response (SVR). Adverse events were recorded monthly. Data were analyzed using χ2 and Fisher’s exact tests as appropriate. Results: We included 102 patients aged 42 to 71 years. Risk factors of transmission were dominated by past history of invasive surgery, RVR was achieved by47% of patients; EVR by 88.2%; and ETR by 74.5%. Twenty seven patients relapsed; we ended with a SVR in 48% of patients. The viral kinetic showed a slow reaction to treatment. Conclusion: The therapeutic response to Pegylated interferon ribavirin combination of blacks from the sub-Sahara, with CHC2 is by far lower than in Caucasians, Black Africans seem to react more slowly to therapy. Pending the arrival of new drugs, therapeutic protocols need to be reconsidered.