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Yousif MM, Ahmed H, Elsadek HM, Shendi AM, Gouda TM, Elsayed IA, Gendia MA, Magdy MM, Lbrahim NF, Sadek AMEM, Zaki AM, Shafeik H, Zahran MH. Real-world safety and effectiveness of retreatment of Egyptian chronic hepatitis C patients not responding to NS5A inhibitor-based therapies. J Viral Hepat 2020; 27:1190-1201. [PMID: 32564500 DOI: 10.1111/jvh.13349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 01/08/2023]
Abstract
The aim of this study was to assess the efficacy and safety of two protocols for retreatment of a cohort of Egyptian patients with chronic hepatitis C (CHC) who relapsed after NS5A inhibitor-based therapy. We conducted a prospective cohort study to assess the safety and efficacy of 12 weeks' retreatment with either combination of sofosbuvir/daclatasvir/simeprevir plus ribavirin (SOF/DCV/SMV/RBV, n = 45) or sofosbuvir/ombitasvir/paritaprevir/ritonavir plus ribavirin (SOF/OBV/PTV/r/RBV, n = 163) in patients who had previously failed NS5A inhibitors-based regimens. The primary end point was SVR 12 weeks after the end of treatment (SVR12). Safety follow-up data were recorded for 60 weeks after the end of treatment. Two hundred-eight patients were included in the study. Of them, 53.4% of patients were females and 40.4% had liver cirrhosis. The most common prior drug combinations were sofosbuvir/daclatasvir (n = 94) and sofosbuvir/daclatasvir plus ribavirin (n = 109). The overall SVR12 rates were 98.1%. In SOF/DCV/SMV/RBV group, 95.6% achieved SVR12, while in SOF/OBV/PTV/r/RBV group, the SVR12 rates were 98.8%. SVR12 was higher in cirrhotic patients (84/84) than noncirrhotic (120/124), P value = .0149. Regarding the safety outcomes, anaemia and fatigue were significantly higher in SOF/OBV/PTV/r/RBV group. Hepatocellular carcinoma (HCC) was reported in eight (3.8%) patients (four in each group). Of them, death was confirmed in four patients. Retreatment of Egyptian CHC relapsed patients with either sofosbuvir/daclatasvir/simeprevir plus ribavirin or sofosbuvir/ombitasvir/paritaprevir/ritonavir plus ribavirin is highly effective and well-tolerated for both noncirrhotic and compensated cirrhotic patients. Incidental de novo HCC and hepatic decompensation are comparable in the two groups.
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Affiliation(s)
- Monkez M Yousif
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Hussien Ahmed
- Faculty of Medicine, Zagazig University, Sharkia, Egypt.,Clinical Research Management Program, Edson College, Arizona State University, Tempe, AZ, USA
| | - Hany M Elsadek
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Ali M Shendi
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Tamer M Gouda
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Islam A Elsayed
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Mohamed A Gendia
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Mahmoud M Magdy
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | - Nevin F Lbrahim
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
| | | | - Ayman M Zaki
- Gastroenterology and Hepatology Unit, Al-Ahrar Educational Hospital, Sharkia, Egypt
| | - Hamdy Shafeik
- Consultant Gastroenterology and Hepatology, Zagazig Viral Hepatitis Treatment Center, Sharkia, Egypt
| | - Mahmoud H Zahran
- Internal Medicine Department, Zagazig University, Sharkia, Egypt
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