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Background: Current standard therapy commonly followed for chronic Hepatitis C Virus (HCV) in Pakistan is interferon alpha plus ribavirin combination therapy (IFN α/ribavirin) and pegylated interferon plus ribavirin (PegIFN/ribavirin). PegIFN/ribavirin has increased rate of sustained virological response than standard IFN α/ribavirin therapy. Objective of current study was to analyze rate of early and delayed response to antiviral treatment as well as rate of relapse response in patients following standard treatment IFN α/ribavirin and in patients following pegylated interferon treatment. Methods: Baseline serum samples of 153 patients enrolled for IFN α/ribavirin and 50 patients for PegIFN/ribavirin were collected. After total RNA extraction, genotyping was and HCV RNA viral load was done. Subsequently HCV RNA viral load was estimated at 4 weeks of treatment, at 12 weeks, at 24 or 48 weeks and finally after 6 months follow up period. All the data was statistically analyzed using fisher's exact test. Results: Total 86 patients out of 153 patients following conventional IFN α/ribavirin therapy completed treatment and 69% of them showed Rapid Virological Response (RVR). Whereas 50 patients following PegIFN/ribavirin treatment completed treatment and 80% of them achieved RVR. Total 64 out of 86 patients following IFN α/ribavirin therapy completed follow up period and 53.5% of them achieved Sustainded Virologcal Response (SVR). Forty-five out of total 50 patients who received PegIFN/ribavirin treatment completed 6 months follow up period and among these 70% achieved SVR. SVR rates were significantly associated with RVR (p < 0.001), age (p < 0.001) and gender (p < 0.01) Conclusions: Rate of sustained virological response can be determined by factors like rapid virological response and age since they share significant association with one another. More over rate of SVR was more prominent in males than in females. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) is a crucial public health problem with approximately 350 million affected people and a death rate of 0.5 to 1.2 million per year worldwide. It proceeds to end-stage liver diseases including cirrhosis with hepatic decompensation and hepatocellular carcinoma (HCC). Pakistan lies in the endemic region with 3% HBV carrier rate in the country. The differences in disease outcome and antiviral treatment response among HBV infected patients are variable in different regions of the world due to marked differences in HBV genotypes. These variants are different in their serological reactivity patterns, virus replication, liver disease severity and antiviral treatment responsiveness. The highly mutating nature of HBV is the major cause of its ever increasing antiviral resistance. Importantly the tyrosinemethionine-aspartate-aspartate (YMDD)-motif mutants emerge during prolonged lamivudine treatments that elicit immune clearance. This review deals with the HBV nature, mutation appearance and particularly emphasizes on lamivudine induced mutations in a conserved region (YMDD motif) which is further worsening the antiviral therapies with passage of time. [ABSTRACT FROM AUTHOR]