Successful treatment of hepatitis C genotype 4 using sofosbuvir, daclatasvir, simeprevir and ribavirin in Egyptian patients with direct-acting antiviral agent treatment failure

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Experimental Hepatology Pub Date : 2022-03-01 DOI:10.5114/ceh.2022.114246

H. Mohamed, Weal Abd El Ghany, R. Yehia, M. Fouad

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Abstract

Introduction In chronic hepatitis C virus (HCV) patients in whom prior direct-acting antiviral agent (DAA) treatment had failed, outcomes after retreatment are optimal. Combination of sofosbuvir (SOF), daclatasvir (DCV), simeprevir (SIM), and ribavirin (RBV) in treatment experienced patients is recommended in current guidelines despite insufficient data. Our aim is to determine the efficacy and safety of SOF, DCV, SIM plus RBV in HCV infected patients who failed prior DAA treatment. Material and methods One hundred and seventeen patients who failed to respond to SOF containing regimens were randomized according to previous response to therapy to non-responders and relapsers. Duration of therapy depends on fibrosis stages. SOF, DCV, SIM and weight based RBV 12 weeks for F1 and F2 (group I) and 24 weeks for F3 and F4 (group II). Results In the non-responder group, a sustained virologic response (SVR) occurred in 100% in group I (F1 and F2) and 97% in group II (F3 and F4). Relapse was 3% in group II (F3 and F4). No patients from either group had breakthrough or non-response. In relapsers SVR was 100% in group I (F1 and F2) and 96% in group II (F3 and F4). Breakthrough, relapse and non-response were 2%, 4%, 2% respectively only in group II (F3 and F4). Conclusions Combining multiple DAAs with different viral targets may be effective treatment protocol in previous non-responders and relapsers with short durations of treatment.

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在埃及直接作用抗病毒药物治疗失败的患者中，使用索非布韦、达司韦、西莫匹韦和利巴韦林成功治疗丙型肝炎基因型4

引言在既往直接作用抗病毒药物（DAA）治疗失败的慢性丙型肝炎病毒（HCV）患者中，再治疗后的结果是最佳的。尽管数据不足，但现行指南建议对有治疗经验的患者联合使用索非布韦（SOF）、达克拉他韦（DCV）、西莫普韦（SIM）和利巴韦林（RBV）。我们的目的是确定SOF、DCV、SIM加RBV在既往DAA治疗失败的HCV感染患者中的疗效和安全性。材料和方法根据既往对无应答者和复发者的治疗反应，将117名对含SOF的方案无应答的患者随机分组。治疗的持续时间取决于纤维化阶段。F1和F2（I组）的SOF、DCV、SIM和基于重量的RBV为12周，F3和F4（II组）为24周。结果在无应答组中，第一组（F1和F2）和第二组（F3和F4）的持续病毒学应答（SVR）分别为100%和97%。第二组（F3和F4）复发率为3%。两组患者均无突破性反应或无反应。在复发者中，I组（F1和F2）的SVR为100%，II组（F3和F4）的SV率为96%。仅在第二组（F3和F4）中，突破、复发和无反应分别为2%、4%和2%。结论将多种DAA与不同的病毒靶点相结合，可能是治疗既往无反应和治疗时间短的复发者的有效治疗方案。

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来源期刊

Clinical and Experimental Hepatology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

2.80

自引率

0.00%

发文量

期刊介绍： Clinical and Experimental Hepatology – quarterly of the Polish Association for Study of Liver – is a scientific and educational, peer-reviewed journal publishing original and review papers describing clinical and basic investigations in the field of hepatology.