Objective: Hepatitis C virus [HCV] infection is a common infection in Thailand and Asian Pacific countries. In Thailand, a regimen of pegylated interferon plus ribavirin has been accepted for HCV treatment since April 2015. Recently, some guidelines do not recommend this regimen for HCV infection. This study aimed to evaluate the efficacy and cost of treatment by this regimen.

Materials and Methods: The study was a prospective study conducted at Khon Kaen University. The inclusion criteria were adult patients’ age between 18 and 65 years with chronic HCV infection, had significant fibrosis (Metavir fibrosis score >F2), and treated with pegylated interferon plus ribavirin for 24 or 48 weeks depending on their genotype. Treatment outcomes and costs were analyzed by evidence of sustained virological response [SVR].

Results: There were 185 patients met the study criteria. There were 18 patients (29.0%) with genotype 1, who were unable to complete the treatment. The average SVR rate was 64.3%; genotype 3 (71.8%) and genotype 1 (50.0%). The total costs for all patients were 25,215,607 baht (US$752,705). Of those, 8,090,037 baht (US$ 241,494, 35.7%) were used for non-SVR group, particularly those patients with genotype 1.

Conclusion: Pegylated interferon plus ribavirin in chronic HCV patients with significant fibrosis had variable SVR outcomes. Genotype 1 and 3 HCV had fair outcomes due to drug intolerability or low SVR rate. Approximately one-third of the total budgets were lost for the non-SVR group.

Keywords: Chronic hepatitis C, Peg-interferon, Ribavirin, Sustained virological response, Intolerability, Cost