Pan genotypic response to combination treatment with Sofosbuvir and Daclatasvir in chronic Hepatitis C patients

Abstract

Background and aims: Hepatitis C is a major cause of liver related morbidity and mortality. Prevalence of HCV infection in India has been variously estimated as 0.9 to 1.9%. With the advent of DAAs, the treatment has been revolutionized with more than 95% cure rate as observed in Caucasian population, while only scarce data on the same are available in the Indian population. Our study is aimed to assess the pan genotypic treatment response (SVR 12) to Sofosbuvir and Daclatasvir combination. Methods: Chronic hepatitis C patients who attended the department of gastroenterology in Calicut Medical College, Kerala, India were included in the study. All those patients with chronic hepatitis or compensated cirrhosis of liver received Sofosbuvir 400 mg and Daclatasvir 60 mg for 12 weeks and those with decompensated cirrhosis of liver received the both the drugs for 24 weeks. HCV RNA levels were measured at the beginning of the treatment, end of treatment and 12 weeks after completion of treatment. Results: 30 patients (22M: 8F) with a mean age of 47±8 years were included, of which 13 (43.3%) had cirrhosis of liver. Of the 13 Cirrhotic patients 9, 3, and 1 were in CTP A, B and C stage respectively. Among the total patients 23(76.7%), 5(16.7%), 2(6.7%) were genotype 3, 1 and 4 respectively .Three patients were treatment failure (previously treated with IFN and RBV combination), two were post renal transplant and one was a hemophilia patient. Median Viral load was: 499801 IU/ml (range: 2.4x10 3 -7.1x10 8 ), Median viral load in chronic hepatitis C patients and cirrhosis of liver patients were 2.8x10 6 and 1.3x10 6 IU/ml respectively. Overall ETR and SVR were 100% in patients across the genotype. No significant adverse reactions were observed. Conclusion: Combination treatment with Sofosbuvir and daclatasvir is very effective in chronic hepatitis patients with or without cirrhosis of liver, across the genotypes (Genotypes 1, 3 and 4)