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CHARACTERISTICS AND OUTCOME OF TREATMENT WITH PEGINTERFERON ALFA-2A (PEGASYS) PLUS RIBAVIRIN (RBV) IN PATIENTS WITH HCV GENOTYPE 4, 5, OR 6 INFECTION: ANALYSIS OF THE CANADIAN PEGASYS EXPANDED ACCESS PROGRAM (EAP)

M Elkashab¹, SS Lee², S Eiloart¹, P Marotta³ on behalf of the Canadian PEGASYS Study Group
¹Toronto Liver Centre; ²University of Calgary; ³London Health Sciences Centre

Little is known about the characteristics and outcomes of treatment in patients with hepatitis C genotype 4, 5 or 6 infection, especially in the Canadian context. We identified genotype 4, 5, and 6 patients in the EAP for the purpose of describing their baseline characteristics and response to treatment.
METHODS: Patients with detectable HCV RNA and compensated liver disease were eligible for the EAP. Treatment was for 48 weeks with PEG-IFNalpha2a +RBV for 48 wks. SVR = HCV-RNA <50 IU/mL at end of follow-up.
RESULTS: Of 2701 patients enrolled in the EAP, 64 (2.4%), 4 (0.2%) and 20 (0.7%) were infected with HCV genotypes 4, 5 and 6, respectively. 22 genotype 4 (34%), 1 genotype 5 (25%) and 6 genotype 6 patients (30%) were relapsers or nonresponders to previous treatment. Among genotype 4, 5 and 6 patients, the mean age was 50, 53 and 49 years; 66%, 75% and 75% were male; and of those with a biopsy result 41%, 25% and 12% had advanced fibrosis (F3-4), respectively. The majority of genotype 4 (75%) and 5 patients (75%) identified themselves as non-Causcasian and non-Asian/non-Pacific islanders. Genotype 6 patients were predominantly Asian/Pacific Islander (85%). SVR was achieved in 33%, 75% and 60% of genotype 4, 5 and 6 patients by ITT.
CONCLUSION: Infection with genotype 4, 5 and 6 is uncommon in the Canadian population and tends to occur in non-Caucasians. The probability of SVR varies by genotype: the lowest in genotype 4 and the highest in genotypes 5 and 6.
Funded by Roche, Canada

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