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Year : 2020  |  Volume : 4  |  Issue : 3  |  Page : 474-481

Efficacy of 24-week treatment with sofosbuvir/daclatasvir/ribavirin in chronic hepatitis C virus-infected Egyptian patients with previous sofosbuvir-based treatment failure

1 Department of Hepatology, National Hepatology and Tropical Medicine Research Institute, Egypt
2 Department of Hepato-gastroenterology and Infectious Diseases, Faculty of Medicine, Al Azhar University for Girls, Cairo, Egypt
3 Department of Endemic Diseases, Faculty of Medicine, Helwan University, Helwan, Egypt

Correspondence Address:
MSc Aisha A Sabal
Department of Hepatology, National Hepatology and Tropical Medicine Research Institute
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjamf.sjamf_73_20

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Background Hepatitis C virus (HCV) is a globally prevalent pathogen and a common leading cause of morbidity and mortality. Egypt has the highest HCV prevalence worldwide, with more than 14.7% of the Egyptian adults having been exposed to the virus. Aim To evaluate the efficacy of 24-week treatment with sofosbuvir (SOF)/daclatasvir/ribavirin in chronic HCV-infected Egyptian patients with previous SOF-based treatment failure. Patients and methods This cohort study was conducted on 247 patients with chronic hepatitis C infection. They all relapsed on SOF-based treatment regimens. Their ages ranged between 22 and 72 years. They were divided according to FIB-4 results into two groups: group I included 132 cirrhotic patients, and group II included 115 noncirrhotic patients. All patients were followed for 24 weeks with liver function tests, complete blood count, and international normalized ratio, and then along with PCR at 4 and 12 weeks after treatment, with recording of adverse events. Results Sustained virologic response (SVR) was achieved in 96% of patients. There was a significant improvement of platelet counts, alanine aminotransferase, and aspartate aminotransferase, causing significant improvement in FIB-4 (points from <1.45 to 3.25), APRI score (points from <0.5 to >2), and LOK index (fractions from <0.2 to >0.5), where all significantly declined at SVR 4 and 12. Anemia and hyperbilirubinemia were the most commonly reported adverse events. Conclusion The combination of SOF plus daclatasvir with ribavirin for 24 weeks has favorable outcomes with high SVR rates and safety profile in treatment of chronic HCV-infected Egyptian patients who relapsed on SOF-based regimens.

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