A sofosbuvir-based quadruple regimen is highly effective in HCV type 4-infected Egyptian patients with DAA treatment failure.

Research Abstract

Background: Although interferon-free DAA-based regimens are highly successful in the vast majority of patients with HCV infection, treatment is nevertheless unsuccessful in some patients. Thus, the present multicenter cohort study aimed to explore the efficacy and safety of SOF with DCV/SMV plus RBV for 12 weeks in Egyptian patients infected with chronic HCV GT4 who failed prior DAA treatments. Experiments: From March 2017 through October 2017, 92 patients enrolled in this study, had chronic infection with HCV GT4 with plasma HCV RNA >10,000 IU/ml. Eligible treatment-experienced patients were treated with SOF plus DCV/SMV plus RBV for 12 weeks. The patient cohort was divided into two groups; cirrhotic and non-cirrhotic patients. Results: Overall, 97% (89/92) of patients who received SOF in combination with DCV/SMV plus RBV achieved SVR12. SVR12 rates were 99% (70/71) and 91% (19/21) in non-cirrhotic and cirrhotic patients, respectively. There were three relapsers, two of whom had cirrhosis. Concerning safety and tolerability, AEs were reported in 64 patients (70%) and generally were mild and transient. Conclusion: the current combination regimen was well tolerated and achieved excellent SVR rates with no virologic response failures at the end of retreatment. Therefore, the careful choice of combining multiple DAAs with different viral targets and non-overlapping resistance may be an effective treatment strategy in difficult-to-cure patients.

Research Keywords

HCV, RBV, simeprevir, daclatasvir, sofosbuvir, Genotype 4. Egyptian