Efficacy and safety of sofosbuvir and daclatasvir in patients with chronic hepatitis C virus induced cirrhosis with Child-Pugh class B

Mayssa El Raziky,Sherif Hamdy,Zeinab Zakaria,Yasser Hamada,Nermin Mohamed Abdelaziz,Mohamed Hassany,Wahid Doss

doi:10.1186/s43066-022-00174-3

Mayssa El Raziky, Sherif Hamdy + Show 5 more

Open Access

https://doi.org/10.1186/s43066-022-00174-3

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Abstract

BackgroundThis study aimed to evaluate the efficacy, safety and tolerability of SOF/DCV ± RBV in a cohort of Egyptian patients with chronic hepatitis C (CHC)-induced cirrhosis with decompensation (class B7–B9).ResultsAfter excluding the 9 patients who withdrew, SVR12 rate according to per protocol analysis was 82.9% (92/111), non-response and relapse rates were 2.7% (3/111) for each, 4 patients died secondary to hematemesis, and 8.1% stopped therapy due to worsening of Child’s class. SVR12 rate was significantly higher among patients with higher baseline WBCs count and lower among patients with Child-Pugh class B9. All treatment intolerant patients had ascites in pre-treatment assessment (P = 0.02). There was a significant decline in the levels of hemoglobin, ALT and AST, and serum bilirubin (P < 0.001) and a significant increase in albumin level (P < 0.001) at the end of treatment when compared to their pre-treatment levels. Follow-up of the three HCC did not show evidence of tumor recurrence.ConclusionsThe SOF/DCV combination ± ribavirin is an effective and safe regimen for patients with CHC induced cirrhosis with mild decompensation. Treatment did not increase the risk of HCC recurrence.

Highlights

This study aimed to evaluate the efficacy, safety and tolerability of SOF/DCV ± RBV in a cohort of Egyptian patients with chronic hepatitis C (CHC)-induced cirrhosis with decompensation
The initial goal of hepatitis C treatment is to eradicate hepatitis C virus (HCV) which is specified by a sustained virological response (SVR), defined as undetectable HCV
The current study aimed to evaluate the efficacy, safety, and tolerability of SOF/DCV ± RBV in a cohort of Egyptian patients with CHC induced decompensated cirrhosis with Child scoreB7–B9

Summary

Introduction

This study aimed to evaluate the efficacy, safety and tolerability of SOF/DCV ± RBV in a cohort of Egyptian patients with chronic hepatitis C (CHC)-induced cirrhosis with decompensation (class B7–B9). Egypt had the highest prevalence of hepatitis C virus infection in the world, and genotype 4 virus is found in more than 90% of patients [1]. Since 2014 several direct acting antivirals (DAAs) have been approved enabling interferon-free antiviral treatments with high SVR rates, and some of them are giving the chance for decompensated (cirrhotic) patients [4]. Sofosbuvir (SOF) is an inhibitor of NS5B-polymerase.It has effectiveness against all genotypes with a high resistance barrier and good tolerability with once daily oral dosing [5]. Reported results from previous clinical studies demonstrated that SOF and DCV combination therapy, have a good tolerability, limited drug to drug interactions, and a high rates

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