Evaluation of Response to Sofosbuvir Based Treatment Regimens in Chronic HCV Patients, MOHAMED A. MOHAMED, MAHMOUD A. KHEDR, MAHA Z. OMAR and AZZA H. EL-SHIEKH
Abstract
Background: HCV is a major cause of liver associated diseases. Egypt by far has the largest national-level HCV prevalence in the world. For a decade, pegylated interferon (PegIFN) and ribavirin (RBV) were the basis of hepatitis C treatment. Sofosbuvir-based therapies have been recently approved for the treatment of chronic HCV infection.
Aim of Work: Was to study the factors that may affect the response to treatment with the approved sofosbuvir-based regimens in Egyptian patients with chronic HCV infection.
Patients and Methods: This study was conducted on 206 chronic HCV infected patients, attending El-Mahalla Hepa-tology Educational Hospital for receiving antiviral therapy (sofosbuvir and RBV with or without PegIFN), according to the national treatment protocol issued in 2014, in the period from November 2014 till December 2015.
Results: They were 206 patients, with a mean age of 50.81±7.51 years and a mean HCV-RNA level of 2591569± 6426474IU/L. The SVR of patients receiving dual therapy was 71.7%, versus 85.6% for triple therapy. There was a significant difference between responders and non-responders to dual therapy as regards the sex (p=0.005), smoking (p=0.047) and serum albumin level (p=0.004), while lower RBV dose was associated with lower response rates, particu-larly in patients receiving triple therapy. On the other hand, dual therapy was associated with more complications than triple therapy. While low platelet count, low serum albumin, high serum bilirubin and high starting ribavirin dose were associated with development of complications during treatment by dual therapy (p<0.001) for each the studied parameters, only baseline hyperbilirubinemia could predict the development of complications during treatment with triple therapy (p= 0.009).
Conclusion: Treatment of chronic HCV patients with sofosbuvir and RBV with or without PegIFN can achieve high SVR rates. Triple therapyis associated with higher SVR and fewer complications than dual therapy.