Low dose ribavirin has been effective in the treatment of incapacitating muco-cutaneous extrahepatic manifestations in patients with hepatitis C with contraindication or no access for approved antiviral treatment

Background and study aimsChronic hepatitis C virus (HCV) is a major public health problem and represents a common cause of chronic liver disease worldwide. The Egyptian Demographic Health Survey (EDHS) has estimated HCV prevalence in Egypt to be 14.7%. HCV can affect multiple organ systems and cause a variety of extrahepatic manifestations. Most of extrahepatic manifestations affect the skin and mucous membranes; such as lichen planus (LP), psoriasis, and leucocytoclastic vasculitis. The treatment of extrahepatic manifestations has been disappointing in patients not indicated for interferon with no access for the new costly all oral treatments.Patients and methodsIn 2014, thirty Egyptian patients with incapacitating mucocutaneous extrahepatic manifestations due to chronic HCV infection, not indicated for interferon, have been randomised into two groups; group I treated with ribavirin (5–10 mg/kg daily divided into 2 doses), and group II treated with local steroids for 3 months. Patients were followed up for 3 months. Dermatology life quality index score has been measured before and after treatment for all patients.ResultsA significant improvement of mucocutaneous lesions has been accomplished in group I in comparison to group II (p < 0.01). All lesions in group I showed a significant improvement except psoriasis (p > 0.05). A significant improvement of dermatology life quality index score has been found in patients in group I when compared to group II (p < 0.05).ConclusionWe conclude that low dose ribavirin was effective in the treatment of incapacitating mucocutaneous extrahepatic manifestations of chronic HCV infection in patients with contraindication or no access to the approved antiviral treatments.