Serum Alpha-Fetoprotein, Albumin and Previous Antiviral Treatment, Can Predict Non-Response to Direct Antiviral Therapy in Egyptian Patients with Chronic Hepatitis-C

Abstract

Background & Aims: Direct acting antiviral therapies (DAAs), are currently the state of the art therapy of chronic Hepatitis C (CHC) giving hope particularly to patients with liver cirrhosis. The aim of the study was to investigate the ability to use baseline data as predictors of non-response to DAAs in patients with CHC. Methods: Baseline demographic and laboratory characteristics were collected for patients with CHC eligible for DAAs therapy. Patients were collected from March 2016 to October 2016 from Damanhur Viral Hepatitis Center (Boheira Governorate, Egypt). Monthly follow up was done during treatment to confirm safety, then at week 12 after the end of treatment to confirm sustained virological response (SVR) using routine laboratory data, ultrasonography, and quantitative HCV-PCR. Results: This observational study included 2446 patients with CHC who received DAAs (combined sofosbuvir and daclatasvir with or without ribavirin). Their mean age was 50 ± 9.5 year and 57.3% were females. About 47.4% were cirrhotic and 299 (12.2%) patients were treatment experienced. 96.24% patients achieved SVR-12. Baseline AFP was significantly higher in non-responders (14.3 ng/ml versus 9.5 ng/ml respectively, P-value < 0.001). Multivariate logistic regression analysis revealed that SVR-12 was significantly associated with being treatment naïve, having higher Albumin levels and having AFP level ≤ 10. Conclusions: The independent factors affecting SVR-12 were AFP level ≤ 10 ng, being treatment naïve, and serum albumin levels.