Muhammad Murtaza Bukhari, Muhammad Arif Nadeem, Muhammad Irfan, Amjad Mahmood, Tariq Masood.
Viral Load & Genotype are the Major Determinants of SVR in Chronic Hepatitis C patients of Azad Kashmir, Pakistan.
Pak J Med Health Sci Jan ;7(1):223-6.

This study was carried out to assess predictive power of some additional factors prevailing in our population taking conventional interferon. So that we can decrease the relapse rate and hence improve SVR. This was observational study carried out at Department of Medicine, DHQ Teaching Hospital Mirpur, Azad Jammu & Kashmir from July 2009 to July 2011. The gender, abnormal Alanine Aminotransferase (ALT) at start of treatment, HCV genotype, achievement of End Treatment Response (ETR) and achievement of Sustained Viral Response (SVR) were the qualitative variables while age, quantity of ALT at start of treatment and HCV viral load were quantitative variables. Out of 235 patients, 75.3% patients achieved ETR while amongst them only 76.8% achieved SVR. ETR and SVR were statistically correlated with age of patients, gender, ALT, Viral Load and HCV Genotype. The ETR was found 76% among male gender as compared to 75% among females. SVR was 2.158 times more among females as compared to males and ETR was 2.98 times more among younger patients with age below 40 years. ETR was found 75% among the patients with abnormal initial ALT and SVR was found 54% among the patients with abnormal initial ALT. ETR was found 76% among the patients with low viral load and SVR was 24.29 times more among patients with low viral load, and the association was statistically significant (p=0.000). The patients with HCV Genotype 3a, 2a, 3b, 2b and untypable had ETR 77%,72%, 81%,75% and 68% respectively and the association was statistically insignificant (p=0.856), while with Genotype 3a, 2a, 3b, 2b and untypable had SVR 58%,54%, 64.5%,65% and 21% respectively and the association was statistically significant (p=0.025). The overall SVR with standard interferon and Ribavirin treatment was low in patients of Azad Kashmir, Pakistan and more dependent on the significant drop-out of the patients after they attained ETR, otherwise SVR was 76.8% in those who came for follow-up.

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