Ribavirin For Treatment Of Chronic Hepatitis Research Articles

Sofosbuvir Add-on to Ribavirin Treatment for Chronic Hepatitis E Virus Infection in Solid Organ Transplant Recipients Does Not Result in Sustained Virological Response

Ribavirin is effective for treating immunocompromised patients with chronic hepatitis E virus infection. However, ribavirin treatment is not always successful. We describe 3 solid organ transplant recipients treated with sofosbuvir and ribavirin after failing ribavirin monotherapy. Complete elimination of hepatitis E virus could not be achieved.

P5428Deterioration of vascular and hemodynamic markers during and after pegylated interferon and ribavirin treatment for chronic hepatitis C

P5428Deterioration of vascular and hemodynamic markers during and after pegylated interferon and ribavirin treatment for chronic hepatitis C

Induction of inosine triphosphatase activity during ribavirin treatment for chronic hepatitis C

BackgroundRibavirin (RBV) is an antiviral agent and the primary component for chronic hepatitis C (CHC) therapy. Hemolytic anemia is limitation for RBV treatment. Inosine triphosphatase (ITPA) activity has been associated with severity of RBV-induced anemia. However, changes in ITPA activity during CHC therapy are unknown. The aim of this study was to measure the time-dependent change in ITPA activity over the RBV treatment. MethodsForty-two patients with CHC were evaluated for ITPA activity over the course of RBV treatment. ResultsThe median value of ITPA activity at start of RBV treatment was 134.2 μmol/h/g hemoglobin (Hb; range, 26.3–251.0 μmol/h/g Hb). The ITPA activity values at 4, 8, and 12 weeks during RBV treatment were 143.2, 202.2, and 225.7 μmol/h/g Hb, respectively, and these ITPA values were significantly elevated compared with the start of treatment (p < 0.001). In patients with ITPA variants, patients with anemia (Hb < 10 g/dL) had greater elevated ITPA activities compared with patients without anemia at 12 weeks. ConclusionOur findings indicate that ITPA activities are elevated with RBV therapy, and this elevation may be a risk of anemia in late therapeutic phase in patients that began with low ITPA activity.

Study of the Efficacy of Triple Therapy of Sofosbuvir, Pegylated INFalpha 2a and Ribavirin in Treatment of Chronic Hepatitis C Patients Genotype 4 with High Fibrosis

Purpose: The aim is evaluation of the efficacy of triple therapy of sofosbuvir, pegylated INFalpha 2a and ribavirin in treatment of chronic hepatitis C (CHC) patients genotype 4 who have high fibrosis. Materials and Methods: Fifty HCV patients with high fibrosis (F3 & F4) were included in the study. Results: SVR rate was 54%; non-responders rate was 12% and relapsers rate was 34%. When comparing SVR between F3 group patients and F4 group, it was 88% and 66% respectively, which means that SVR was higher in the F3 group. Conclusion: Triple therapy including pegylated INFalpha 2a is not an ideal therapy in treatment of CHC patients genotype 4 with cirrhosis because of low sustained virological response rates and high incidence of side effects.

Secondary Skin Hyperpigmentation During with Peginterferon Alpha and Ribavirin Treatment for Chronic Hepatitis C Virus Infection: Case Report

Secondary Skin Hyperpigmentation During with Peginterferon Alpha and Ribavirin Treatment for Chronic Hepatitis C Virus Infection: Case Report

Predictive potential of IL-28B genetic testing for interferon based hepatitis C virus therapy in Pakistan: Current scenario and future perspective.

In Pakistan which ranked second in terms of hepatitis C virus (HCV) infection, it is highly needed to have an established diagnostic test for antiviral therapy response prediction. Interleukin 28B (IL-28B) genetic testing is widely used throughout the world for interferon based therapy prediction for HCV patients and is quite helpful not only for health care workers but also for the patients. There is a strong relationship between single nucleotide polymorphisms at or near the IL-28B gene and the sustained virological response with pegylated interferon plus ribavirin treatment for chronic hepatitis C. Pakistan is a resource limited country, with very low per capita income and there is no proper social security (health insurance) system. The allocated health budget by the government is very low and is used on other health emergencies like polio virus and dengue virus infection. Therefore it is proposed that there should be a well established diagnostic test on the basis of IL-28B which can predict the antiviral therapy response to strengthen health care set-up of Pakistan. This test once established will help in better management of HCV infected patients.

Acute Pancreatitis Associated with Pegylated Interferon α-2b and Ribavirin Treatment of Chronic Hepatitis C

Acute pancreatitis is an uncommon side effect of pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) combination therapy. In South Korea, There is a no report of acute pancreatitis associated PEG-IFN α-2b plus RBV combination therapy. Here, acute pancreatitis associated with PEG-IFN α-2b plus RBV treatment is described in two patients with chronic hepatitis C. We started on weekly subcutaneous injection of PEG-IFN α-2b plus daily RBV. During this therapy, acute pancreatitis occurred in these patients without other causes of acute pancreatitis. We thought that the cause of acute pancreatitis in these patients was PEG-IFN α-2b and RBV. We stopped the treatment of PEG-IFN α-2b and RBV, and patients were improved. Key words: Pancreatitis; Interferons; Ribavirin; Chronic hepatitis C

Cost comparison of treating chronic hepatitis C genotype one with pegylated interferons in Ukraine.

Based on the pivotal trial showing no clinically relevant differences between pegylated interferon α-2b (Peg-α-2b) and α-2a (Peg-α-2a) combined with ribavirin for treatment of chronic hepatitis C virus (HCV) genotype 1 infection in Ukraine, a cost-minimization analysis was performed using a 1 year time horizon and both a health care and patients’ perspective. A decision tree reflects treatment pathways. Drug costs were based on drug labeling and adjusted to the average body mass in Ukraine. Subgroup analysis was applied to deal with heterogeneity of patient’s weight causing dose changes. A break-even price of Peg-α-2a and Peg-α-2b (based on the average dose) was calculated. Univariate sensitivity analyses and probabilistic sensitivity analysis were carried out to reflect decision uncertainty. For an average body weight, total medical costs per patient differ from US$9220 for Peg-α-2b to US$9513 for Peg-α-2a from a health care perspective, and from US$15,212 to US$15,696 from a patients’ perspective. Sensitivity analyses show these results are robust. With average body weight, the break-even price of Peg-α-2b may be 7.3% higher than Peg-α-2a to have similar total costs.

Pegylated interferon pharmacokinetics and self-reported depressive symptoms during antiviral treatment for chronic hepatitis C.

Pegylated interferon-2a (PegIFN-2a)+ribavirin treatment for chronic hepatitis C is often associated with depressive symptoms. Previous studies have failed to explore whether PegIFN-2a pharmacokinetic variability plays an etiologic role in PegIFN-2a-induced mood disorders. The objective of this investigation was to evaluate the association between trough PegIFN-2a concentration at treatment week 4 ("PegIFN-2a Cmin4") and an increase in depressive symptoms. Using data from Virahep-C, the association between PegIFN-2a Cmin4 and the following depression outcomes were evaluated using the Center for Epidemiological Studies-Depression scale (CES-D): (1) change in CES-D score from baseline to week 12; (2) greatest difference in CES-D score between baseline and weeks 4, 12, or 24; and (3) occurrence of severe depressive symptoms (CES-D greater than 23) at weeks 4, 12, or 24. One post-hoc analysis examined whether PegIFN-2a exposure during the first week of treatment was associated with change in CES-D score from baseline to week 4. No significant associations between PegIFN-2a Cmin4 and the depression outcomes were observed (p>0.05). Exploratory analyses suggest a possible relationship between PegIFN-2a exposure during the first week of therapy and CES-D score change from baseline to week 4 (p=0.03). PegIFN-2a concentration levels from baseline to week 4 do not predict the onset and severity of depressive symptoms during 24 weeks of antiviral therapy; however PegIFN-2a levels during the first week of treatment may predict depressive symptoms in the first 4 weeks, earlier than anticipated and warrants further exploration.

Efficacy and Tolerance of Interferon β Plus Ribavirin Treatment for Chronic Hepatitis C Patients with Depression or Thrombocytopenia Comparison with Pegylated Interferon α Plus Ribavirin Treatment

Objective: Limited data has been reported comparing natural human interferon β (nIFNβ) and pegylated IFN-α (PEG-IFNα) when Ribavirin (RBV) is combined. This case-control study was done to compare the efficacy and adverse effects of a combination treatment of nIFNβ or PEG-IFNα plus RBV for chronic hepatitis C patients. Methods: Sixty patients with chronic hepatitis C, 42 infected with hepatitis C virus (HCV) genotype 1 and 18 infected with genotype 2, were treated with nIFNβ plus RBV. Of them, 23 (38.3%) suffered pre-treatment severe depression. Their data was compared with 60 undepressed patients treated with a combination of PEG-IFNα plus RBV. nIFNβ was given intravenously and PEG-IFNα was injected subcutaneously. Results: Sustained virological response (undetectable HCV RNA at 24 weeks after the end of treatment) did not significantly differ between the nIFNβ and PEG-IFNα treated patients (genotype 1, 21.4% vs. 33.3%, P=0.328; genotype 2, 72.2% vs. 88.9%, respectively, P=0.402). None of the nIFNβ treated patients showed exacerbation of depression, while 7 (11.7%) of 60 PEG-IFNα treated patients developed severe depression or malaise. The platelet count of nIFNβ treated patients increased to higher than baseline after week 8, but the platelet count of PEG-IFNα treated patients decreased throughout the treatment. There were significant differences of the changes of platelet counts between the both groups throughout the treatment (all P<0.001). Conclusion: nIFNβ plus RBV treatment was well tolerated by chronic hepatitis C patients with depression or thrombpcytopenia.

Dilated cardiomyopathy and hypothyroidism associated with pegylated interferon and ribavirin treatment for chronic hepatitis C: case report and literature review

Pegylated interferon alpha (Peg IFN-α) in combination with ribavirin is the backbone of treatment in chronic hepatitis C (CHC). Cardiotoxicity due to interferon therapy is rare. The most frequent cardiovascular complications are arrhythmias and ischemic manifestations. Cardiomyopathy is extremely rare but can be life threatening. We present the case of a 41-year-old female patient with CHC in whom Peg IFN-α induced dilated cardiomyopathy and hypothyroidism. Chest radiography showed an enlarged and globular cardiac silhouette and pulmonary congestion. Echocardiography showed decreased left ventricular systolic function with an ejection fraction of 32% and fractional shortening of 15%. Cardiomyopathy had a complete remission after cessation of antiviral therapy with short-term heart failure medications and supportive care. Then we review the current literature about interferon induced cardiomyopathy in patients with HCV infection, as well as share our clinical experience in diagnosing and managing this rare complication.

P279 Reduction of hepatocellular carcinoma recurrence by pegylated interferon alpha-2b plus ribavirin treatment for chronic hepatitis C patients

P279 Reduction of hepatocellular carcinoma recurrence by pegylated interferon alpha-2b plus ribavirin treatment for chronic hepatitis C patients

Early phase viral kinetics of chronic hepatitis C patients receiving telaprevir-based triple therapy: A comparison of two real-time PCR assays

Monitoring hepatitis C virus (HCV) kinetics during antiviral treatment is recommended for determining the best form of treatment management. We compared the measurement of HCV RNA by two Real-time PCR assays during the first 12weeks phase of telaprevir in combination with pegylated interferon α2b and ribavirin treatment for chronic hepatitis C patients. The viral kinetics of 65 patients with HCV genotype 1b was assessed. HCV RNA was tested at baseline, on day 3, and every week from 1 to 12 by both the first-generation Roche COBAS® AmpliPrep/COBAS® TaqMan® HCV (CAP/CTM) assay and the Abbott RealTime HCV (ART) assay. A total of 910 serum samples were obtained from the 65 patients. Of these, 168 (28.5%) of the 590 samples HCV RNA negative by CAP/CTM were positive by ART. In contrast, 17 (3.9%) of the 439 samples HCV RNA negative by ART were positive by CAP/CTM. The rates of HCV RNA negativity by ART at weeks 3, 4, and 5 were significantly lower than those by CAP/CTM (21.5% vs. 50.8%, 36.9% vs. 70.8% and 44.6% vs. 81.5%; P<0.001, P<0.0001 and P<0.05, respectively). Although the ART is superior for the determination of HCV RNA negativity, the predictive value of detectable HCV RNA for non-sustained virological response (non-SVR) by CAP/CTM is higher than by ART at weeks 4, 6, and 8. We also found that 16 (24.6%) by CAP/CTM and 28 (43.1%) by ART had a reappearance of residual HCV RNA during the telaprevir treatment period. However, the reappearance of residual HCV RNA was not associated with non-SVR. In conclusion, a significant difference was found between the two real-time PCR assays for the assessment of virological response based on undetectable HCV RNA.

Sa1045 Dynamic Changes of Health-Related Quality of Life After Pegylated Interferon and Ribavirin Treatment for Chronic Hepatitis C

Sa1045 Dynamic Changes of Health-Related Quality of Life After Pegylated Interferon and Ribavirin Treatment for Chronic Hepatitis C

1267 – Functional polymorphism in the interleukin-6 gene (IL-6 rs1800795), and depression induced by interferon-alpha and ribavirin during the HCV treatment

The inflammatory response system is important in the pathophysiology of depressive symptoms that are frequent side effects of interferon-alpha (IFN-alpha) treatment. The functional rs1800795 IL-6 promoter SNP [-174 IL-6 (G > C)] has been described, with ‘CC’ genotype associated with lower synthesis of IL-6. The present study was carried out to determine whether rs1800795 IL-6 polymorphism is associated with severity of depression developed during IFN-alpha and ribavirin treatment. We included 54 Caucasian patients receiving pegylated IFN-alpha and ribavirin treatment for chronic hepatitis C virus infection in the prospective cohort study. Symptoms of depression (Montgomery - Åsberg Depression Rating Scale, MADRS, Beck Depression Inventory, BDI) and neuroticism (Eysenck Personality Questionnaire - Revised, EPQ-R/N) were assessed before treatment, just after treatment and 24 weeks after treatment. The mean MADRS ratings were higher in subjects with genotype ‘CC’ (p> 0.1). On the other hand, the BDI and EPQR/ N ratings were higher, and more stable in patients with ‘GG’ genotype (p> 0.1). Higher changes and the lowest values 24 weeks after the end of treatment were associated with ‘CC’ genotype (p< 0.05). The mean values were as follows (begin, end of treatment, 24 weeks after treatment): MADRS ‘CC’ (8.7, 11.3, 4.8), ‘GG’ (6.9, 11.1, 6.0); BDI ‘CC’ (6.9, 8.9, 3.2), ‘GG’ (8.4, 11.3, 6.2); EPQ-R/N ‘CC’ (8.3, 10.1, 7.3), ‘GG’ (10.4, 10.9, 9.2). Genotype ‘CC’ of IL-6 rs1800795 polymorphism is associated with bigger differences in BDI and EPQ-R/N ratings during IFN-alpha and ribavirin treatment, and lower ratings after treatment.

Extended peginterferon plus ribavirin treatment for 72 weeks versus standard peginterferon plus ribavirin treatment for 48 weeks in chronic hepatitis C genotype 1 infected slow-responder adult patients.

The standard length of peginterferon plus ribavirin treatment for chronic hepatitis C virus (HCV) genotype 1 infected patients is 48 weeks. However, the number of patients demonstrating a sustained virological response is not high. In order to improve sustained virological response, extending the length of the treatment period has been suggested. To study the benefits and harms of extended 72-week treatment in comparison with 48-week treatment with peginterferon plus ribavirin in patients with chronic HCV genotype 1 infection who have shown a slow antiviral response. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, and LILACS until November 2011. We identified further trials by reviewing reference lists and contacting principal authors. Trials were eligible for this review if they included patients infected with hepatitis C virus genotype 1 who had a slow antiviral response, and if those patients were randomised to completing 72 weeks versus 48 weeks of treatment with pegylated interferon and ribavirin. Two authors independently assessed the trials for risk of bias, and extracted the data. The primary outcomes were overall mortality, liver-related mortality, and liver-related morbidity. We extracted data separately according to two definitions of slow responders: 1) patients with ≥ 2 log viral reduction but still detectable HCV RNA after 12 weeks of treatment and undetectable HCV RNA after 24 weeks of treatment; 2) patients with detectable HCV RNA after four weeks of treatment. We calculated risk ratios from individual trials as well as in the meta-analyses of trials. We included seven trials with 1369 participants. All trials had high risk of bias. Five trials used our first definition of slow responders, and three other trials (including one that used both definitions) used the second definition. None of the included trials mentioned our primary outcomes. However, regarding the secondary outcomes, extension of the treatment period to 72 weeks increased the sustained virological response according to both definitions (71/217 (32.7%) versus 52/194 (26.8%); risk ratio (RR) 1.43, 95% confidence interval (CI) 1.07 to 1.92, P = 0.02, I(2) = 8%; and 265/499 (53.1%) versus 207/496 (41.7%); RR 1.27, 95% CI 1.07 to 1.50, P = 0.006, I(2) = 38%), with a risk difference of 0.11 and calculated number needed to treat of nine. The end of treatment response was not significantly different between the two treatment groups. The number of participants who relapsed virologically was found to be lower in the groups that had been treated for 72 weeks using both definitions (27/84 (32.1%) versus 46/91 (50.5%); RR 0.59, 95% CI 0.40 to 0.86, P = 0.007, I(2) = 18%, 3 trials; and 85/350 (24.3%) versus 146/353 (41.4%); RR 0.59, 95% CI 0.47, 0.73, P < 0.000001, I(2) = 0%, 3 trials). The length of treatment did not significantly affect the adherence (247/279 (88.5%) versus 252/274 (92.0%); RR 0.95, 95% CI 0.84 to 1.07, P = 0.42, I(2) = 69%, 3 trials). In the single trial that reported adverse events, no significant difference was seen between the two treatment groups. This review demonstrates higher a proportion of sustained virological response after extension of treatment from 48 weeks to 72 weeks in HCV genotype 1 infected patients in whom HCV RNA was still detectable but decreased by ≥ 2 log after 12 weeks and became negative after 24 weeks of treatment, and in patients with detectable HCV RNA after four weeks of treatment with peginterferon plus ribavirin. The observed intervention effects can be caused by both systematic error (bias) and random errors (play of chance). There was no reporting on mortality and the reporting of clinical outcomes and adverse events was insufficient. More data are needed in order to recommend or reject the policy of extending the treatment period for slow responders.

Evaluation of the adverse effect of premature discontinuation of pegylated interferon α‐2b and ribavirin treatment for chronic hepatitis C virus infection: Results from Kyushu University Liver Disease Study

Pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) treatment of chronic hepatitis C virus (HCV) infection is associated with a substantially elevated risk of discontinuation. The aim of this study is to evaluate the reason for premature discontinuation during PEG-IFN α-2b and RBV treatment due to adverse effects in patients with chronic HCV infection. A total of 2871 Japanese patients who had chronic HCV infection treated with PEG-IFN α-2b and RBV were screened. We prospectively investigated the reasons for premature discontinuation of treatment classified by sex and age, and analyzed the timing of discontinuation. Of the 2871 patients, 250 (8.7%) discontinued treatment because of adverse effects. The main reasons for premature discontinuation were neurovegetative symptoms (n = 77, 30.8%), depression-related syndrome (n = 46, 18.4%), hematologic effects (n = 41, 16.4%) and dermatologic effects (n = 27, 10.8%). The rate of discontinuation of treatment for patients aged ≥ 65 years was significantly higher than for patients aged < 65 years, for both men (P < 0.0001) and women (P = 0.0121). Moreover, the frequency of discontinuation due to neurovegetative symptoms, depression-related syndrome, and hematologic effects for men aged ≥ 65 years was significantly higher than for those aged < 65 years (P = 0.0001, P = 0.0016, and P = 0.0170, respectively), but not for women. Premature discontinuation due to the adverse effects of PEG-IFN α-2b and RBV treatment by patients with chronic HCV infection is mainly due to neuropsychiatric symptoms and is more common for older than for younger patients.

Insulin resistance undermines the advantages of IL28B polymorphism in the pegylated interferon alpha-2b and ribavirin treatment of chronic hepatitis C patients with genotype 1

Recent studies have suggested that insulin resistance exerts a strong influence on chronic hepatitis C virus (HCV) infection. We analyzed pretreatment factors useful for predicting sustained virological response (SVR), especially interleukin (IL) 28B polymorphism and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). This cohort study consisted of 328 chronic hepatitis C patients with HCV genotype 1 who were treated for 48 weeks with pegylated interferon (PegIFN) α-2b and ribavirin (RBV). Genotyping of the polymorphisms in the IL28B gene region (rs8099917) on chromosome 19 was performed on DNA collected from each patient. No significant difference in IL28B genotype distribution was found according to HOMA-IR. Multivariate analysis identified the IL28B TT genotype (OR=5.97, 95% CI 2.15-16.55, p=0.0006) and the baseline HOMA-IR (OR=0.65, 95% CI 0.48-0.87, p=0.0044) as significant, independent pretreatment predictors of SVR. Receiver operating characteristic analyses to determine the optimal threshold values of HOMA-IR for predicting SVR showed that the areas under the curve (AUC) were high for both IL28B TT (AUC=0.774, HOMA-IR cut-off value: 2.45) and IL28B TG/GG genotypes (AUC=0.772, HOMA-IR cut-off value: 1.55). For HCV genotype 1, both IL28B and baseline HOMA-IR are independent pretreatment predictors of SVR in patients treated with PegIFNα-2b and RBV. Insulin resistance undermines the advantages of IL28B polymorphism to obtain SVR.

The Importance of a Prior Psychiatric Examination in Pegylated Interferon and Ribavirin Combination Treatment for Chronic Hepatitis C

Some patients receiving pegylated interferon and ribavirin treatment for chronic hepatitis C are forced to discontinue the treatment due to psychiatric disorders. We performed a retrospective study to evaluate whether pre-treatment psychiatric examinations could increase successful completion rates for this treatment. A total of 535 patients who started pegylated interferon-α-2b and ribavirin treatment at 6 hospitals affiliated with our hospital were included in this study. The patients were divided into two groups. Those who had visited a psychiatric clinic before treatment were Group A (N=223), and those who did not visit a psychiatric clinic before treatment were Group B (N=312). We analyzed the rate of discontinuation due to psychiatric disorders in the two groups. The rate of discontinuation due to psychiatric disorders in Group A was found to be significantly lower than that of Group B (1.8% (4/223) vs. 6.1% (19/312), P=0.035). In Group A, 6.1% (4/65) discontinued the treatment due to psychiatric disorders, while the comparable rate in Group B was 27% (19/68) (P=0.0004). Among patients who presented with psychiatric symptoms during treatment, the rate of treatment completion was significantly higher in Group A than in Group B (69.2% (18/26) vs. 5.0% (1/20), P=0.0067). In patients with a history of psychiatric symptoms, no discontinuation due to psychiatric disorder was observed in Group A. A psychiatric examination before pegylated interferon and ribavirin treatment was found to positively contribute to the successful completion of the treatment.

Efficacy and safety of peginterferon alfa-2a and ribavirin treatment of chronic hepatitis C in the Republic of Serbia

Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. Pegylated interferon alfa-2a or 2b (PEG IFN alfa-2a or 2b) and ribavirin (RBV) represent a standard treatment of chronic hepatitis C (CHC). Sustained virological response (SVR), defined as continued undetectable HCV RNA 24 weeks after completion of treatment, is universally considered as an indicator of treatment efficacy. The aim of this study was to determine efficacy and safety of PEG IFN alfa-2a and RBV treatment in patients with CHC in Serbia. One hundred seventy-six patients with CHC were included in this multicenter trial from 8 reference centers in Serbia. The patients were treated with standard PEG IFN alfa-2a and RBV protocol. We performed the following virological testing: anti-HCV (ELISA), HCV RNK (quantitative PCR), HCV genotype (type-specific PCR), HBsAg, anti-HBs, anti-HBc and anti-HIV (ELISA). Histological activity and the degree of fibrosis were determined according to the Metavir scoring system. Potential predictors for achieving SVR were evaluated using multivariable logistic regression analysis. Of the treated patients with CHC 65.9% were male, and 60.2% of them aged over 40 years. Of the treated patients 68.2% had infection over 5 years, 63% had HCV RNA >400.000 IU/mL, 76.1% had HCV G1/4, and 60.1% had a mild to moderate liver fibrosis. SVR was achieved in 78.9% of patients (G1/4 79.1%; G2/3 78.1%). The factors that indicated a poorer efficacy of the treatment were age >40 (p<0.05), high basal viremia (p=0.013), and the reduction of PEG IFN alfa-2a and RBV doses, with interruption of therapy (p<0.001). Of the treated patients 45.9% had adverse affects (G1/4 50.8%; G2/3 29.7%). Treatment of CHC with PEG IFN alfa-2a and RBV was efficient in 78.9% of patients. The safety profile of therapy was satisfactory. Longer therapy increases the possibility of the development of adverse affects. No life-threatening adverse effects were recorded in our patients.