Sofosbuvir and daclatasvir in the treatment of chronic hepatitis c virus infection at benghazi medical center: Our experience

Abstract

Background: The treatment of hepatitis C virus (HCV) has changed dramatically with the rapid advent of numerous new antiviral agents, including direct-acting antivirals which become the standard of care for HCV infection. Our aim was to investigate the safety and efficacy of combined sofosbuvir (SOF)/daclatasvir (DCV) for HCV in our patients. Patients and Methods: The cohort comprises 157 HCV-infected patients followed from October 2016 to May 2018. The inclusion criteria were treatment experienced or naive and 18 years or older. Cirrhotic patients included were Child-Turcotte-Pugh A (CTP-A) whereas CTP-B-C patients were excluded. All patients had been treated with SOF/DCV 400/60 mg with or without ribavirin. The primary endpoint was sustained virological response at week 12 (SVR12) and significant adverse events. Results: A total of 157 patients were enrolled in the study with a mean age of 47.74 ± 18.2 years including 48.2% males. Ninety percent of patients were Libyan. One hundred and fifteen (72.9%) patients were treatment naive. Fifty-eight (36.9%) patients were cirrhotic. The adverse effects of the drug were reported in 25/157 (15.9%); the most commonly reported side effects were gastrointestinal upset and dizziness, whereas hepatic decompensation occurred in five patients and all were cirrhotic and none required drug cessation. Undetectable viremia at the end of treatment was observed in 156 patients (99.3%), and one patient had been labeled as nonresponder. Undetectable viremia 12 weeks after the end of treatment was achieved in 155 patients (98.8%), and only one relapsed. Conclusion: SOF and DCV are safe and efficacious with an SVR12 of about 99.0% among our cohorts. The next step is to improve screening and access to these therapies for eradication of hepatitis C infection from the world and Libya as well in the near future.