Abstract
Objective:To determineRapid & End treatment response of patients treated with Sofosbuvir in Chronic Hepatitis C at tertiary care hospital.Methods:It was an observational study conducted at Memon Medical Institute from January 2016 to July 2017. The inclusion criteria for patients was 18 years of age or older, having chronic infection with HCV. Total=201 received sofosbuvir with or without interferon in our OPDs. Patients were categorized into Treatment naïve, treatment experienced and decompensated chronic liver disease. Pregnant patients and those not willing to participate were excluded. Initially genotyping and Quantitative HCV RNA test was done.Results:A total of 201 subjects were included in the study with mean age of the patients was 46.22± 14.41 years. Of 201 patients, n= 131 (65.2%) chronic hepatitis C, compensated cirrhosis n= 47(23.4%), and with decompensated cirrhosis n=23(11.4%). Most commonly genotype 3 n= 180 (89.6%) was present followed by genotype 1 n=9(4.5%), genotype 2 n=1(0.5%), genotype 4 n=1(0.5%). Of patients with genotype 3, 123 received dual therapy and 57 were given triple therapy. After one month of therapy HCV RNA by PCR, 200(99.5%) achieved RVR, 199(99%) achieved ETR and SVR achieved in 178(88.5%) while remaining 1 patient did not achieved RVR, 2 ETR and 12 patients did not achieved SVR and remaining 11 SVR lost follow up.Conclusion:Sofosbuvir has shown to be very effective andsuccessfulwith achievement of virological response with little or no resistance in all genotypes mainly genotype 3 treated in our study population. The promising results of our study will aid in better outcomes and therefore help in eradication of the virus.
Highlights
Hepatitis C infection represents a global health problems affecting 200 million subjects worldwide.[1,2,3] Previous Studies indicate that around, three to four million people are newly infected each year resulting in an estimated 350,000 deaths annually.[4,5] Pakistan is estimated to have the second highest patient burden
Hepatitis C and the population suffering from this disease is said to be between 4.5-8.2%,6 among these 78% of subjects belong to genotype 3 in contrast to the western population where this genotype is less common.[7]
Pakistan is said to have the highest prevalence of hepatitis C and the population suffering from this disease is said to be between 4.5-8.2%
Summary
Hepatitis C infection represents a global health problems affecting 200 million subjects worldwide.[1,2,3] Previous Studies indicate that around, three to four million people are newly infected each year resulting in an estimated 350,000 deaths annually.[4,5] Pakistan is estimated to have the second highest patient burden. A large number of subjects with HCV infection remained untreated due to absolute or relative contraindications to interferon therapy, like hepatic decompensation, autoimmune disease, and psychiatric illness.[8] adverse effects like ‘flu-like symptoms, fatigue, fever, leucopenia or thrombocytopenia can be unpleasant and sometimes serious, leading to dose reduction or discontinuation of treatment.[9] In this regard the introduction of Sofosbuvir has proven to be groundbreaking as far as cure for hepatitis C is concerned. The safety and efficacy of sofosbuvir as proved by ELECTRON trial previously has it the basis of combination antiviral therapy in patients with chronic HCV genotype 1, 2 and 3 infections, including both treatment-naive and treatmentexperienced patients.[11,12] No dose adjustment is required for creatinine clearance higher than 30 ml/ minutes, along with minimal side effects and the advantage of once daily oral dose makes it superior and more desirable other therapies of HCV.[13]
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