Sofosbuvir plus ribavirin with or without interferon for HCV

What is it about?

Background &Aims: Sofosbuvir is a powerful drug for treatment of hepatitis C virus (HCV) infection. In comparison to preceding remedies, sofosbuvir-based regimens provide a higher cure rate, fewer side effects, and much lower duration of treatment. The aim of the work was to assess the efficacy and safety of sofosbuvir plus ribavirin with or without peginterferon-alfa in treatment of a cohort of Egyptian patients with hepatitis C virus infection. Methods: Two hundred treatment naive patients who were HCV-antibody positive and HCV RNA by PCR positive aged more than 18 years were enrolled in the study and patients were classified into two groups: Group I which included 100 patients who received dual therapy with sofosbuvir plus oral weight based ribavirin for 24 weeks and Group II which included 100 patients triple therapy with sofosbuvir plus oral weight based ribavirin (as with the dual therapy) and a 180 mcg Peg-INF alpha 2a subcutaneous injection weekly for 12 weeks. The primary end point was a sustained virological response at 12 weeks after end of treatment determined by quantitative PCR for HCV. Results: Both patients groups had high sustained virological response that was higher in patients receiving triple than dual therapy (94% vs 83%). The adverse events that occurred in the two groups of patients were more evident in group of patients receiving triple therapy. The side effects were mainly flu like symptoms. Conclusions: the triple regimen of Pegylated interferon, sofosbuvir plus ribavirin is safe and effective in treatment of Egyptian patients with hepatitis C virus as well as sofosbuvir and ribavirin alone with real life SVR12 rates of 94% in the triple therapy versus 83% in the dual therapy

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Why is it important?

Egypt has the highest prevalence of HCV infection worldwide, so it is not surprising that the highest burden of advanced liver disease from HCV globally is in Egypt [10-13]. Six treatment options are available in 2016 for patients infected with HCV genotype 4, in settings where none of the proposed options is available, the double combination of sofosbuvir and ribavirin, or the triple combination of pegylated IFNa, ribavirin and sofosbuvir remain acceptable for selected patients who are likely to respond to these regimens [14, 15] We conducted our study on 200 treatment naive patients who received dual and triple therapy. Both our patients groups had high sustained virological response that was higher in patients receiving triple than dual therapy (94% vs 83%).

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