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Sofosbuvir plus Daclatasvir with or without ribavirin for treatment of chronic HCV genotype 4 patients: real-life experience

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Abstract

Introduction

New regimens involving direct-acting antiviral agents have recently been approved for the treatment of HCV. Our aim was to assess the efficacy and safety of 12 or 24 weeks of Sofosbuvir 400 mg plus Daclatasvir 60 mg, with or without ribavirin (800–1000 mg) in treating chronic hepatitis C genotype 4 patients.

Methods

This is an open-label observational study that describes the effect of 12 week or 24 weeks of daily oral Sofosbuvir (SOF) 400 mg plus Daclatasvir (DCV) 60 mg with or without ribavirin (RBV) with dose adjustment if indicated. It included the first 1168 patients that fulfilled the inclusion and exclusion criteria and treated in the Egyptian Liver Research Institute and Hospital, Mansoura, Egypt.

Results

Sustained viral response after 12 weeks of end of treatment (SVR12) was achieved in 96.6% (95% CI 95.1–98.2%) of the patients receiving 12 weeks of DCV + SOF treatment, in 95.7% (95% CI 93.6–97.8%) of the patients receiving 12 weeks of DCV + SOF + RBV, in 93.3% (95% CI 90.0–96.6%) of those receiving 24 weeks of DCV + SOF, and in 92.2% (95% CI 85.4–98.9%) of patients receiving 24 weeks of DCV + SOF + RBV treatment. SVR12 rate was significantly higher in patients with no cirrhosis receiving DCV + SOF only for 12 weeks or 24 weeks (97.4 and 97.4%, respectively) than in patients with cirrhosis (91.7 and 88.9%, respectively). The most common adverse events were fatigue, headache, insomnia, and anemia. No treatment-related serious adverse events or death were reported in the studied groups.

Conclusion

Treatment with SOF (400 mg) plus DCV (60 mg), with or without RBV (800–1000 mg) for 12 or 24 weeks, was effective and well tolerated in chronic hepatitis C genotype 4 patients. SVR rates were higher for patients with no cirrhosis. Addition of RBV has benefit only in treatment-experienced group receiving 24 weeks.

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Abbreviations

AE:

Adverse events

BMI:

Body mass index

CI:

Confidence interval

CHC:

Chronic hepatitis C

DAA:

Direct-acting antivirals

DCV:

Daclatasvir

ECG:

Electrocardiography

ELRIAH:

Egyptian Liver Research Institute and Hospital

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus

IFN:

Interferon

IQR:

Inter-quartile range

kPa:

Kilo Pascals

LLOQ:

Lower limit of quantification

NS5A:

Non-structural protein 5A

PegIFNα:

Pegylated interferon alpha

RBV:

Ribavirin

RNA:

Ribonucleic acid

SD:

Standard deviation

SOF:

Sofosbuvir

SPSS:

Statistical package for social sciences

SVR:

Sustained virologic response

SVR12:

Sustained virologic response after 12 weeks

ULN:

Upper limit of normal

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Acknowledgements

The authors thank the patients that allowed the use of their data in this report and the treating physicians for their time and contributions to this work.

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Authors and Affiliations

  1. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura-Damietta Road, Mansoura, Dakahlia, Egypt

    G. Shiha, R. Soliman, M. ElBasiony, A. A. Hassan & N. N. H. Mikhail

  2. Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    G. Shiha & M. ElBasiony

  3. Tropical Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt

    R. Soliman

  4. Biostatistics and Cancer Epidemiology Department, South Egypt Cancer Institute, Assiut University, Assuit, Egypt

    N. N. H. Mikhail

Authors
  1. G. Shiha
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  2. R. Soliman
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  3. M. ElBasiony
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  4. A. A. Hassan
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  5. N. N. H. Mikhail
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Contributions

GS was involved in design, interpretation, and drafting of the manuscript. RS, ME, and AAH were involved in data acquisition and interpretation. NNHM was involved in data analysis and interpretation. All authors critically reviewed and revised the manuscript for content and approved the final draft for publication.

Corresponding author

Correspondence to G. Shiha.

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The authors do not have any disclosures to report.

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Shiha, G., Soliman, R., ElBasiony, M. et al. Sofosbuvir plus Daclatasvir with or without ribavirin for treatment of chronic HCV genotype 4 patients: real-life experience. Hepatol Int 12, 339–347 (2018). https://doi.org/10.1007/s12072-018-9861-2

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  • DOI: https://doi.org/10.1007/s12072-018-9861-2

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