Pattern of Response to Sofosbuvir and Daclatasvir +/- Ribavirin Regimen in Chronic Hepatitis C Patients

Abd El Hamed, Reem M.; Galal, Ghada M.; Ahmed, Nagwa S.; Saif Al-Islam, Mahmoud

doi:10.21608/ejhm.2022.232816

Pattern of Response to Sofosbuvir and Daclatasvir +/- Ribavirin Regimen in Chronic Hepatitis C Patients

Document Type : Original Article

Authors

10.21608/ejhm.2022.232816

Abstract

Background: With the advent of direct-acting antivirals (DAAs) for hepatitis C virus (HCV), there has been a marked increase in the number of patients who achieve sustained virological response (SVR). Several factors mediate the response to therapy as immunologic and genetic factors.
Objective: We aimed to assess the pattern of response to sofosbuvir and daclatasvir +/-ribavirin regimen in chronic hepatitis C (CHC) patients and to study the predictors of non SVR (relapse).
Patients and methods: This prospective study was conducted on 506 consecutive HCV-infected patients. Abdominal ultrasonography, liver function tests, alpha-fetoprotein (AFP), HCV polymerase chain reaction (PCR), complete blood count (CBC), random blood glucose, C-X-C motif chemokine ligand 10 (CXCL10), Child-Pugh score, and some serum fibrosis indices were performed. After completion of the course of treatment, all patients were followed up for 6 months and then categorized into sustained virological responders and non-sustained virological responders (relapsers).
Results: Out of the 506 HCV-infected patients, 497 (98.2%) achieved SVR, and 9 (1.8%) experienced relapse. Response rates to sofosbuvir and daclatasvir +/-ribavirin in cirrhotic patients were lower than those without cirrhosis. The p < /span>resence of liver cirrhosis (LC) and the need for receiving triple therapy were the main factors that predicted relapse in univariate analysis. CXCL10 levels showed statistically insignificant differences between responders and relapsers, between cirrhotic and non-cirrhotic patients, and between pretreatment and post-treatment levels.
Conclusions:Response rate of CHC patients to sofosbuvir and daclatasvir +/-ribavirin is excellent and relapse only occurred in a minority of patients (1.8%). Cirrhotic patients showed higher relapse rate than non-cirrhotic (55.65% vs 44.4%).

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