Efficacy and Safety in Difference Combination of Sofosbuvir in Treatment of Chronic Hepatitis C Virus

Abstract
Background: Hepatitis C virus infects about 185 million people equating 2.8% of worldwide population. Management of chronic HCV patients traditionally depended on combination of peg-interferon (IFN) with ribavirin but this regimen showed many serious side effects beside its non-satisfactory efficacy. In 2013, a second generation of direct acting antiviral agents (DAAs) gave a promising efficacy and safety. Although many IFN free regimens were approved, further evaluations are needed for these regimens.
Aim of Study: To compare safety and efficacy of Sofosbuvir in combination with Daclatasvir (DCV) or Ledipasvir (LDV) or Simeprevir (SIM) in treatment of chronic HCV patients.
Patients and Methods: This is a prospective study con-ducted on 150 patients of chronic HCV who visited Al-Ahrar Educational Hospital in Zagazig National Committee for the Control of Viral Hepatitis (NCCVH) from January to Septem-ber of 2017 and were selected according to the inclusion and exclusion criteria set by the (NCCVH).
Patients were assigned into three groups: 50 patients received (SOF/DCV ± RBV), 50 patients received (SOF/LDV ± RBV) and 50 patients received (SOF/SIM ± RBV). Three regimens were given for 12 weeks.
Results: In this study, the mean age of the 50 patients of each group was (52.6±9 years) in SOF/DCV group, (48.2±13.5 years) in SOF/LDV group and (50.26±10.6 years) in SOF/SIM. A total of 150 patients including 93 (62%) males & 57 (38%) females.
Adverse events occurred in (18%) of SOF/DCV group, (18%) of SOF/LDV group and (40%) of SOF/SIM group. The most common adverse events occurred in three groups were; hyperbilirubinemia (20%) in SOF/SIM group, (8%) in SOF/ DCV group and (4%) in SOF/LDV group (Table 2), thus SOF/SIM group showed a higher incidence of adverse events occurrence but adverse events in three groups were mild (not sever enough to cause treatment discontinuation).
Sustained Virological Response (SVR) rate was nearly similar in three groups: (100%) of SOF/LDV group, while it was achieved (98%) of SOF/SIM group and (98%) of SOF/DAC group. This results showed no statistically signif-icant difference.
Conclusions: Sofosbuvir based antiviral regimen in com-bination with (DCV, LDV and SIM) were tolerable with no obvious side effect and showed high efficacy in management of chronic HCV with nearly similar SVR.