Abstract
BackgroundCure of chronic hepatitis C (HCV) in HIV/HCV co-infected patients is a priority due to their increased risk of complications. Daclatasvir and sofosbuvir treatment regimens with or without ribavirin are considered an important chance for better HCV treatment in patients with HIV/HCV co-infection. This study aimed at the assessment of safety and efficacy of sofosbuvir-daclatasvir treatment regimens in HIV/HCV co-infected Egyptian patients.ResultsThirty HIV/HCV co-infected adult patients were included. All patients completed the study duration without major problems or drug interactions, HCV PCR was negative for all patients at the end of treatment, yet 12 weeks after ending treatment, only one patient (3.33%) had HCV relapse.Liver enzymes showed a significant decrease by the end of treatment and 12 weeks after end of treatment in comparison with their values before treatment (P-value = 0.0001). CD4 counts as well showed significant increase. There was non-significant change in serum albumin, total bilirubin, alfa fetoprotein, complete blood count (CBC), coagulation profile, random blood sugar, or serum creatinine. Ultrasonographic findings did not show significant difference.ConclusionCombination of daclatasvir and sofosbuvir have showed 96.67% sustained virologic response at 12 weeks after treatment (SVR 12) among HIV/HCV co-infected patients, with a good safety profile. Moreover, the treated patients showed a significant increase in CD4 lymphocytic count.
Highlights
Cure of chronic hepatitis C (HCV) in Human immune deficiency virus (HIV)/Hepatitis C virus (HCV) co-infected patients is a priority due to their increased risk of complications
All participants were subjected to full history taking, clinical examination, laboratory investigations (including complete blood count (CBC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum bilirubin, serum albumin, prothrombin time (PT), international normalized ratio (INR), alfa feto protein (AFP), serum creatinine, random blood sugar, quantitative Polymerase chain reaction (PCR) for HCV and HIV, Cluster of differentiation (CD4) T-lymphocyte count) and abdominal ultrasonography
All enrolled patients were Child A, all of them completed the study duration without any major problems, quantitative HCV PCR was negative for all patients at the end of treatment, yet 12 weeks after ending treatment only one patient (3.33%) had HCV relapse
Summary
Cure of chronic hepatitis C (HCV) in HIV/HCV co-infected patients is a priority due to their increased risk of complications. This study aimed at the assessment of safety and efficacy of sofosbuvir-daclatasvir treatment regimens in HIV/HCV co-infected Egyptian patients. Daclatasvir and sofosbuvir co-administration has pangenotypic anti HCV effect through inhibition of both NS5A, NS5B proteins, and are safe and effective for Mohamed et al Egyptian Liver Journal (2021) 11:26 treatment of chronic hepatitis C genotype 4 infected patients with minimal adverse events [4]. Daclatasvir and sofosbuvir have limited pharmacokinetic interactions with antiretroviral drugs, and dose adjustments for daclatasvir in patients receiving moderate inducers or strong inhibitors of cytochrome P450 3A4 are straightforward. This combination may be valuable for treating patients with HIV/HCV co-infection [6]
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