Chronic Hepatitis C is endemic in many regions worldwide. Roughly 71 million people are
infected with HCV all over the world .Egypt has been among the highest prevalence rates of HCV in
the world. HCV is a major cause of chronic hepatitis, hepatic cirrhosis and hepatocellular carcinoma,
moreover the most common cause of liver transplantation. Portal hypertension induced esophageal
varices is one of life threatening complications results from liver cell failure leading to many
mortalities and co-morbidities. The spread of HCV infection in Egypt is thought to be due to needle reuse during mass treatment programs for Schistosmiasis during late fifties till the early eighties.
Unfortunately, transmission continues to occur, primarily through iatrogenic sources such as blood
transfusion, injections and dental cares. Many lines of treatment were approved through years however
the most promising ones the direct acting antivirals (DAAs) as those medications target specific steps
within the HCV life cycle. A retrospective observational study, sample was based on provided data of
101 Egyptian Chronic HCV patients, how had been treated with sofosbuvir between the year 2015 and
2016 at one of the reference centers under the authority of MOHP compared with 101 egyptian patients
infected with HCV who didn’t receive any type of antiviral treatment. Baseline laboratories, HCV
RNA PCR, abdominal ultrasound, upper GI endoscopy was done for all patients in both groups, same
investigations was done after 3 months, 6 months, 1 year for both groups The sample included 202
patients, divided over 2 arms treated and untreated with proportion 1:1, mean age for the whole sample
were 51.1 ± 10.3 years old with high prevalence to males more than females n = 129 (63.8%), n = 73
(36.1%) respectively. Baseline characters showed significant differences in ALT, AST, AFP, INR, HB,
PLT, albumin, F-score, upper GI endoscope and proportion of patients with cirrhosis with p value <
0.05. After 3 months of treatment with DAAs patients had significant reduction of HB and PLT with p
value 0.03 and 0.005 respectively. There was significant difference between treated and untreated arms
in terms of progressive liver cirrhosis( p 0.0001) , ascites( p 0.0001) and HFL( p 0.005) favoring
treatment group over untreated group. Majority of treated sample didn’t experience relapse) 96%(
while only) 5%( relapsed post treatment, multivariate analysis revealed that relapse is correlated to
liver cirrhosis with p value 0.013, PCR after 3 months of finishing treatment with p value 0.0001,
relapse was correlated with increased fatigability in treated patients with (p 0.0001) HCV PCR load
showed significant correlation to relpase after 3 months, moreover HCV PCR after 3 months is
significantly correlated to relpas. DAAs have Higher safety and tolerability and the side effects of
three groups were not sever enough to lead to treatment discontinuation. |
