Efficacy of Nitazoxanide in the Treatment of Chronic Hepatitis C Virus (HCV)

Inclusion Criteria: * Adult (male or female), 18 to 65 years of age, with chronic HCV infection * BMI \< 35 * Liver biopsy showing chronic hepatitis with significant fibrosis using Ishak scoring system * Compensated liver disease; serum bilirubin \< 1.5 mg/dl, INR (international normalized ratio) no more than 1.5, serum albumin \> 3.4, platelet count \> 75,000 mm, and no evidence of hepatic decompensation (hepatic encephalopathy or ascites) * Acceptable hematological and biochemical indices (hemoglobin 13g/dl for men and 12 g/dl for women; neutrophil count 1500/mm3 or more and serum creatinine \< 1.5 mg/dl * Patients must be serum hepatitis B surface antigen (HBsAg) negative * Negative Antinuclear Antibodies (ANA) or titer of \< 1:160 * Serum positive for anti-HCV antibodies and HCV-RNA * Abdominal Ultrasound obtained within 3 months prior to entry in the study * Electrocardiogram for men aged \> 40 years and for women aged \> 50 years * Normal fundus examination * Ensure strict measures to avoid conception for both male and female participants by using a proper contraception measure all throughout the course of treatment and six months later * Female patients must not breast feed during therapy Exclusion Criteria: * Patients who previously received interferon * HgbA1c \> 7.5 (glycoslylated haemoglobin)or history of diabetes mellitus * BMI \> 34 * Women who are pregnant or breast-feeding * Males whose female partners are either pregnant or of child-bearing potential or not using birth control and are sexually active * Other causes of liver disease including autoimmune hepatitis * Transplant recipients receiving immune suppression therapy * Screening tests positive for anti-HAV IgM Ab, HBsAg, anti-HBc IgM Ab or anti-HIV Ab * Decompensated cirrhosis, history of variceal bleeding, ascites, hepatic encephalopathy, CTP score \> 6 (Child-Turcot-Pugh) or MELD score \> 8 * Absolute neutrophil count \< 1500 cells/mm3; platelet count \< 135,000 cells/mm3; hemoglobin \< 12 g/dL for women and \< 13 g/dL for men; or serum creatinine concentration ≥ 1.5 times ULN (upper limit of normal) * Hypothyroidism or hyperthyroidism not effectively treated with medication * Alcohol consumption of \> 40 grams per day or an alcohol use pattern that will interfere with the study * History or other clinical evidence of significant or unstable cardiac disease * History or other clinical evidence of chronic pulmonary disease associated with functional impairment * Serious or severe bacterial infection(s) * History of severe or uncontrolled psychiatric disease, including severe depression, history of suicidal ideation, suicidal attempts or psychosis requiring medication and/or hospitalization * History of uncontrolled severe seizure disorder * History of immunologically mediated disease requiring more than intermittent anti-inflammatory medications for management or that requires frequent or prolonged use of corticosteroids * Patients with clinically significant retinal abnormalities * History of hypersensitivity or intolerance to nitazoxanide or any of the excipients comprising the nitazoxanide tablets, peginterferon alfa-2a injectable solution or ribavirin tablets