Spur-of-the-Moment Modification in National Treatment Policies Leads to a Surprising HCV Viral Suppression in All Treated Patients: Real-Life Egyptian Experience

J Interferon Cytokine Res. 2018 Feb;38(2):81-85. doi: 10.1089/jir.2017.0121. Epub 2018 Jan 22.

Abstract

The aim of this study was to retrospectively analyze the outcome of an unscheduled change in national Egyptian policies for the treatment of hepatitis C virus (HCV), which was transpired as a result of a reduction in interferon supplies, and to manage patients who already started interferon-based therapy. After completing a priming 4-weeks course of sofosbuvir/pegylated interferon/ribavirin (SOF/PEG IFN/RBV), a 12-weeks course of sofosbuvir/daclatasvir (SOF/DCV) combination was initiated. We evaluated the sustained virologic response at 12 weeks posttreatment (SVR12) for 2 groups of patients; Group 1, which included patients who had the previous regimen with IFN priming, and group 2, which included the first consecutive group of patients who received SOF/DCV for 12 weeks from the start without IFN priming. All group 1 patients (1,214 patients) achieved SVR12 (100%) and this was statistically significant when compared with the overall SVR12 in group 2 [8,869 patients with sustained virologic response [SVR] of 98.9%] (P value <0.001). No serious adverse events were reported in both groups. In this real-life treatment experience, interferon-based directly acting antiviral treatment with SOF/PEG IFN/RBV as a priming for 4 weeks, followed by SOF/DCV combination for 12 weeks, led to HCV viral suppression in all treated patients.

Keywords: DAAs; Egypt; HCV; interferon.

MeSH terms

  • Antiviral Agents / pharmacology*
  • Carbamates
  • Egypt
  • Female
  • Hepacivirus / drug effects*
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • Imidazoles / pharmacology*
  • Interferon-alpha / pharmacology*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pyrrolidines
  • Retrospective Studies
  • Ribavirin / pharmacology*
  • Sofosbuvir / pharmacology*
  • Valine / analogs & derivatives

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Interferon-alpha
  • Pyrrolidines
  • Ribavirin
  • Valine
  • daclatasvir
  • Sofosbuvir