Direct-Acting Antivirals in Chronic Hepatitis C Genotype 4 Infection in Community Care Setting

Vijay Gayam, Mazin Khalid, Amrendra Kumar Mandal, Muhammad Rajib Hussain, Osama Mukhtar, Arshpal Gill, Pavani Garlapati, Binav Shrestha, Debra Guss, Jagannath Sherigar, Mohammed Mansour, Smruti Mohanty

Abstract


Background: Limited data exists comparing the safety, tolerability, and efficacy of direct-acting antivirals (DAAs) in patients with chronic hepatitis C genotype 4 (HCV GT-4) in the community practice setting. We aim to evaluate the treatment response of DAAs in these patients.

Methods: All the HCV GT-4 patients treated with DAAs between January 2014 and October 2017 in a community clinic setting were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy with sustained virologic response (SVR) at 12 weeks post treatment (SVR12), and adverse reactions were assessed.

Results: Fifty-two patients of Middle Eastern (primarily Egyptian) descent were included in the study. Thirty-two patients were treated with ledipasvir/sofosbuvir (Harvoni®) ± ribavirin, 12 patients were treated with ombitasvir/paritaprevir/ritonavir/dasabuvir (ViekiraPak®) ± ribavirin, and eight patients were treated with sofosbuvir/Velpatasvir (Epclusa®). Ten patients (19.2%) had compensated cirrhosis. Overall, SVR at 12 weeks was achieved in 94% in patients who received one of the three DAA regimens (93.8% in Harvoni® group, 91.7 % in ViekiraPak® group and 100% in Epclusa® group). Prior treatment status and type of regimen used in the presence of compensated cirrhosis had no statistical significance on overall SVR achievement (P value = 0.442 and P value = 0.091, respectively). The most common adverse effect was fatigue (27%).

Conclusions: In the real-world setting, DAAs are effective and well tolerated in patients with chronic HCV GT-4 infection with a high overall SVR rate of 94%. Large-scale studies are needed to further assess this SVR in these groups.




Gastroenterol Res. 2018;11(2):130-137
doi: https://doi.org/10.14740/gr999w

 


Keywords


Chronic hepatitis C genotype 4; Direct-acting antiviral agents; Sustained virologic response; Adverse drug reactions

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