Background and study aim: Major changes have emerged during the last few years in the
treatment of chronic HCV infection. Several direct acting antiviral agents (DAAs) have been
developed showing potent activity with higher rates of sustained virological response. This
study shows comparison between triple therapy regimen (Peginterferon/ Ribavirin/
Sofosbuvir) and dual therapy regimen (Simprevir/Sofosbuvir) concerning efficacy and safety
for Egyptian patients with chronic HCV infection.
Patients and Methods: This retrospective comparative study included 500Egyptian patients
with chronic HCV infection, randomly selected from BeniSuef centre of treatment of viral
hepatitis affiliated to the National committee for control of viral hepatitis (NCCVH). They
were classified into two groups; triple therapy group included 250 patients had received
pegylated interferon alpha, ribavirin and sofosbuvir for 12 weeks and dual therapy group
included 250 patients had received sofosbuvir and simeprevir for 12weeks. All patients were
monitored for treatment safety and efficacy.
Results: In the triple therapy group, mostly observed clinical side effects were; flu like
illness (40% of patients), GI manifestations %20.8)of patients) and psychological
manifestations (10.4% of patients) while photosensitivity (22% of patients), flu like illness
(18.8% of patients) and GI manifestations (4.8% of patients) were the most frequently
occurring clinical adverse effects in dual therapy group. Anemia %62.4)of patients) and
leucopenia (49.6% of patients) were the mostly observed hematological abnormalities in
triple therapy group while hyperbilirubinemia %38)of patients) was the mainly observed
biochemical abnormality in dual therapy group. In the triple therapy group, the end of
treatment response (ETR) rate was %95.6while sustained virological respons (SVR) rate was
91.2%. In dual therapy group, ETR rate was 95.6 % while SVR rate was 93.6.%
Conclusion: The dual therapy (Simeprevir and Sofosbuvir) regimen is more tolerated than
triple therapy (Peginterferon, Ribavirin and Sofosbuvir) regimen for Egyptian patients with
chronic HCV infection. There was no statistically significant difference as regard sustained
virological response between both triple therapy and dual therapy regimens. |
