Digestive Diseases and Sciences

, Volume 63, Issue 5, pp 1341–1347 | Cite as

Retreatment Efficacy of Sofosbuvir/Ombitasvir/Paritaprevir/Ritonavir + Ribavirin for Hepatitis C Virus Genotype 4 Patients

  • Adel Abdel-Moneim
  • Alaa Aboud
  • Mohamed Abdel-Gabbar
  • Mohamed Zanaty
  • Mohamed Ramadan
Original Article



The current standard of care for patients with chronic hepatitis C virus (HCV) infection is a combination of direct-acting antiviral agents (DAAs). However, rare clinical trials have been reported on the combination regimen of sofosbuvir (SOF) with ombitasvir, paritaprevir, and ritonavir (OBV/PTV/r) plus ribavirin (RBV) for treated patients with HCV genotype 4 (GT4) infection.


To clarify the retreatment efficacy and safety of the recent regimen, SOF with OBV/PTV/r + RBV, for chronic HCV GT4-experienced patients who failed treatment with DAA-based regimens.


A total of 113 treatment-experienced patients were allocated for the completion of their treatment period. The enrolled patients were treated orally with SOF plus a fixed dose combination of OBV/PTV/r + RBV, which was administered orally based on the patients’ tolerability. The primary end point was a sustained virological response (HCV RNA < 15 IU/mL), observed 12 weeks after the end of the treatment (SVR12).


Among all patients, the treatment-experienced patients with SOF plus OBV/PTV/r + RBV had a higher SVR12 rate (97%; 109/113). Further, SVR12 was achieved by 98% (81/83) of non-cirrhotic patients and 93% (28/30) of cirrhotic patients. Additionally, the most common adverse events reported included fatigue, headache, insomnia, nausea, and dyspnea.


The recent multi-targeted regimen of SOF plus OBV/PTV/r + RBV was well tolerated and achieved excellent SVR rates among retreatment-experienced Egyptian patients with prior DAA treatments failure, thus providing an alternative regimen for the retreatment of difficult-to-cure HCV GT4 patients.


Egyptian patients Sofosbuvir Ombitasvir Paritaprevir Ritonavir Ribavirin 



The authors acknowledge with grateful appreciation to the staff member of the National Treatment Centers in Beni-Suef, Egypt. We thank the patients and their families, as well as Mss/Asmaa Mahmoud Gaber for her generous help in figures preparation.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Molecular Physiology Division, Faculty of ScienceBeni-Suef UniversityBeni SuefEgypt
  2. 2.Tropical Medicine Department, Faculty of MedicineBeni-Suef UniversityBeni SuefEgypt
  3. 3.Biochemistry Division, Chemistry Department, Faculty of ScienceBeni-Suef UniversityBeni SuefEgypt
  4. 4.Biotechnology Department, Postgraduate Studies for Advanced ScienceBeni-Suef UniversityBeni SuefEgypt

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