Rapid and Sustained Virologic Response of Triple Therapy in Egyptian Patients with Chronic Hepatitis C Virus Infection

Abstract

Egypt has the highest prevalence of antibodies to hepatitis C virus (HCV) in the world, estimated nationally at 14.7%. There are over 500,000 new infected persons per year by hepatitis C virus. More than 90 % of Egyptian patients are infected with genotype IV. Liver mortality in Egypt reaches 40,000 per year, making 10% of total mortality, and comes second after heart diseases. The goal of antiviral therapy is to cure hepatitis C via a sustained elimination of the virus. Importantly, long-term benefits of sustained virological response (SVR) are the reduction of HCV-related hepatocellular carcinoma and overall mortality. The development of new direct acting anti-viral for the treatment of chronic hepatitis C patients give us and the patients a new hope for cure from that disease and its complication. Our study which was conducted in the national hepatology and tropical medicine research institute (NHTMRI) on 200 Egyptian patients who were eligible to be treated with Sofosbuvir, Interferon and ribavirin. All the included patients received Pegylated Interferon 180 mcg SC injection once / week, Weight-based RBV (1000 mg [<75 kg] to 1200 mg [≥75 kg]) oral capsule divided every 8 hours and sofosbuvir (400 mg) oral capsule every 24 hours for 12 weeks. The enrolled patients were divided into two groups, 100 naïve patients, and 100 patients who experienced IFN therapy before (43 patients were relapser after INF treatment, 34 patients were non responder to INF treatment while other 23 patients were breakthrough during INF treatment) We started with 204 patients, 4 patient were excluded due to discontinuation of the therapy, 2 of them were naïve, one stopped the therapy after development of ascites and the other stopped the therapy due to severe thrombocytopenia. The other 2 patients one of them was from relapser group and the other one was from the non-responder group and stopped treatment after development of