Quadruple Therapy Offers High SVR Rates in Patients with HCV Genotype 4 with Previous Treatment Failure

Yousry Esam-Eldin Abo-Amer; Rehab Badawi; Mohamed El-Abgeegy; Heba Fadl Elsergany; Ahmed Abdelhaleem Mohamed; Sahar Mohamed Mostafa; Hatem Samir Alegaily; Shaimaa Soliman; Sally Elnawasany; Sherief Abd-Elsalam

doi:10.1155/2020/9075905

Quadruple Therapy Offers High SVR Rates in Patients with HCV Genotype 4 with Previous Treatment Failure

Adv Virol. 2020 Jul 24:2020:9075905. doi: 10.1155/2020/9075905. eCollection 2020.

Affiliations

¹ Hepatology, Gastroenterology, and Infectious Diseases Department, Mahala Hepatology Teaching Hospital, Gharbia, Egypt.
² Tropical Medicine Department, Tanta University, Tanta, Egypt.
³ Hepatology and Liver Transplantation Departments, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.
⁴ Hepatology, Gastroenterology, and Infectious Diseases Department, Benha Faculty of Medicine, Benha, Egypt.
⁵ Department of Public Health and Community Medicine, Menofia University, Menofia, Egypt.

Abstract

Background and aims: Direct-acting antivirals (DAAs) have made a revolution in hepatitis C virus (HCV) treatment with promising reduction of HCV infection and disease morbidities. However, unfortunately, treatment failure still occurs in about 5-15% of patients treated with DAA-based combination regimens. The primary aim of the study was to assess the efficacy and safety of a quadruple regimen of (sofosbuvir, daclatasvir, and simeprevir with a weight-based ribavirin) in chronic HCV DAAs-experienced patients.

Methods: This observational, open-label prospective study was carried out on 103 genotype 4 hepatitis C virus-infected patients who failed to achieve SVR12 after sofosbuvir-daclatasvir with or without ribavirin. Patients were treated for three months with sofosbuvir (400 mg), daclatasvir (60 mg), and simeprevir (150 mg) with a weight-based ribavirin dosage (1000-1200 mg/d). Response to treatment was determined by quantitative PCR for HCV at 3 months after the end of treatment (SVR12), and adverse events during the treatment were recorded.

Results: SVR was achieved in 100 patients (97.1%) at week 12 after treatment. No dangerous or life-threatening adverse events were recorded.

Conclusions: Retreatment of HCV genotype 4 patients with quadruple therapy is a good therapeutic option and achieves high response rates with minimal side effects.