A Study on the Efficacy of 24 Weeks of Sofosbuvir, Daclatasvir with Ribaravin in the Treatment of Chronic Hepatitis C Patients with Cirrhosis, Genotype 1 and 3.

Treatment of Chronic Hepatitis C Patients with Cirrhosis

Abstract

Background: A number of new interferon free regimens involving direct-acting antiviral agents have recently been approved in EASL 2016 guidelines for the treatment of chronic hepatitis c, cirrhotic patients with genotype1 and 3. Our aim was to assess the efficacy of one such combination of Sofosbuvir, Daclatasvir with Ribaravin after a period of 24 weeks of treatment. Subjects and Methods: 200 patients with hepatitis C and cirrhosis infected with genotype 3 and 1 were included in our study. They were treated with Sofosbuvir 400mg, Daclatasvir 60 mg and weight based Ribavirin for 24 weeks. Response to treatment was assessed 12 weeks after the end of treatment with a sensitive assay (SVR12). Results: Sustained virological response after 12 weeks of end of treatment (SVR12) was achieved in 97.8% of the patients. Among the 4 patients who did not achieve SVR, all were infected with genotype 3 suggesting comparatively greater difficulty in treating this genotype with the available DAAs. Treatment had to be discontinued in 3 patients due to rise in serum creatinine following acute gastroenteritis. 2 patients died due to sepsis. The most common treatment related adverse events were fatigue, headache, cough and sleep related disturbances. No treatment related adverse events related in discontinuation of treatment. Conclusion: Combination of Sofosbuvir and Daclatasvir with weight based Ribavirin for 24 weeks is highly effective and safe in treating cirrhotic HCV patients with Genotypes 3 and 1.