Abstract
Introduction: limited data exists on efficacy of short course therapy with peg interferon, ribavirin and sofosbuvir for chronic hepatitis C genotype 4 infection. We assessed the efficacy and tolerability of combination regimens involving sofosbuvir in patients infected with chronic hepatitis C genotype -4 in a retrospective cohort study. Methods: We retrospectively reviewed medical records of 37 patients with chronic hepatitis c genotype 4 treated between Jan 2013 to June 2015. Twenty-nine of the 37 patients were treated with Peg-Interferon 180mcg subcutaneously weekly with daily weight based ribavirin in combination with fixed dose sofosbuvir for 12 weeks. Three patients each received interferon free sofosbuvir + ribavirin and ledipasvir + sofosbuvir (Harvoni) regimens. Two patients were treated with simeprevir and sofosbuvir at standard doses. Results: Majority of the patients (N=33) were from Middle eastern or Egyptian origin. Eighty percent (N=30) were men and 19% (N=7) were women. Among all patients, 37% (N=14) were treatment experienced and 13% (N=5) had cirrhosis at baseline. Nine patients were co infected with human immunodeficiency virus. End of treatment was not recorded in one patient and sustained virologic response was not available for 4 patients. Two patients discontinued the treatment due to adverse reactions. Excluding patients, who discontinued treatment regimen and who don't have documented ETR and 12 week SVR rate, overall end of treatment response and sustained virologic response rate at 12 weeks post treatment were 100% (34/34) and 93.5% respectively (29/31). Hundred percent of the patients treated with interferon, ribavirin and sofosbuvir, attained 12 week sustained virologic response. One of the two patients who relapsed after treatment was treated with sofosbuvir and ribavirin and the other patient received simeprevir and sofosbuvir regimen. Most common adverse reactions were leukopenia (27%), followed by fatigue (21%), anemia (19%) and thrombocytopenia (16%). One patient developed severe skin reaction after 4 weeks of treatment and the other patient decompensated with esophageal variceal bleeding and both discontinued the treatment.Figure 1Figure 2Conclusion: Our results suggest that short course treatment with peg interferon, ribavirin with direct acting antiviral agent sofosbuvir still a suitable option for treating patients with chronic hepatitis C genotype 4 with excellent sustained virologic response and acceptable adverse events.
Published Version
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