Sofosbuvir and Ribavirin in Chronic Hepatitis C Virus Patients with No Response or Relapse with Interferon Therapy
DOI:
https://doi.org/10.36570/jduhs.2020.3.856Keywords:
Chronic hepatitis C, Direct acting antivirals, Relapser, non responderAbstract
To determine the response rate to sofosbuvir and ribavirin in chronic Hepatitis C Virus (HCV) patients who did not respond or relapsed with interferon therapy. A case series study was performed at Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2017- January 2019. HCV RNA positive were initiated in eligible patients with sofosbuvir 400mg once daily and ribavirin 400mg orally according to body weight for six months. Rapid viral response (RVR) [normal/undetectable ALT and AST level or very low HCV RNA at 4-6 weeks]. HCVRNA, CP, ALT were checked after 3 months of stopping treatment to confirm sustained virologic response (SVR). Of 100 cases, 16 (16%) were non-responders while relapse was observed in 84 (84%) patients. Among the 13 cirrhosis patients, 11 (84.6%) achieved SVR. Females had a significantly higher response rate as compared to males (p value 0.034). The sustained virological response rate in interferon treated chronic hepatitis C patients retreated with sofosbuvir and ribavirin was found satisfactory.
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2. Jiwani N, Gul R A Silent Storm: Hepatitis C in Pakistan Journal of Pioneering medical sciences volume 1 issue 3 October – December 2011.
3. Nouroza F, Shaheena S, Mujtaba G, Noreen S. An overview on hepatitis C virus genotypes and its control Egyptian Journal of Medical Human Genetics Volume 16, Issue 4, October 2015, Pages 291-298
4. Yip B, Nguyen L, Nguyen MH Management of Chronic Hepatitis C among Asian Americans N A J Med Sci. 2014;7(1):38-45.
5. Ahmed W, Arif A, Qureshi H ,Alam SE, Ather R, Fariha S, Waquar J Factors influencing the response of Interferon therapy in Chronic Hepatitis C patients Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (2): 69-73
6. Chou R, Carson S, Chan BKS, et al. Drug Class Review: Pegylated Interferons for Chronic Hepatitis C Infection: Final Report website http://www.ncbi.nlm.nih.gov/books/NBK10664/ accessed on 25 Sept 2019
7. Yoshida EM, Sherman M, Bain VG, Cooper CL, Deschênes M, Marotta PJ, Lee SS, Krajden M, Sullivan HW, Bailey RJ, Usaty C, Peltekian K, Retreatment with pegylated interferon alpha-2a and ribavirin in patients with chronic hepatitis C who have relapsed or not responded to a first course of pegylated interferon-based therapy Can J Gastroenterol. Mar 2009; 23(3): 180–184.
8. Hyun Chin Cho; Geum-Youn Gwak; Yong Han Paik; Moon Seok Choi; Joon Hyeok Lee; Kwang Cheol Koh; Byung Chul Yoo; Seung Woon Paik Pegylated Interferon and Ribavirin in the Retreatment of Chronic Hepatitis C in Korea September 2013 Gut & Liver.
9. Gupta V, Kumar A, Sharma P, Arora A Newer direct-acting antivirals for hepatitis C virus infection: Perspectives for India Indian J Med Res. 2017 Jul; 146(1): 23–33. doi: 10.4103/ijmr.IJMR_679_15: PMC5719604
10. Chun-Jen Liu , Pei-Jer Chen , Ding-Shinn Chen , Tai-Chung Tseng , Jia-Horng Kao Review Article Perspectives on dual hepatitis B and C infection in Taiwan Journal of the Formosan Medical Association (2016) 115, 298e305
11. Christoph Höner zu Siederdissen & Markus Cornberg Review: Clinical Trial Outcomes Sofosbuvir for the treatment of patients with genotype 2 or 3 chronic hepatitis C virus infection Clin. Invest. (2014) 4(4), 361–371
12. Carmen Landaverde, Jennifer T. Wells, Julio Gutierrez, Fred Poordad,
Treatment of Patients with Hepatitis C Virus Genotype 3: Where Are We Now? Clinical Liver Disease, Vol 6, No 4, October 2015 79-81
13. Farooqi JI, Alam A, Ali Z Management of Patients with Chronic Hepatitis C in Pakistan PSH Clinical Guidelines Statement 2017 sofosbuvir accessed on 27th March 2017
14. Sarwar S, Khan AA. Sofosbuvir based therapy in Hepatitis C patients with and without cirrhosis: Is there difference? Pak JMedSci.2017;33(1):37-41.doi: https://doi.org/10.12669/pjms.331.12163
15. Iqbal S, Yousuf MH, Yousaf MI. Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study. World J Gastroenterol 2017; 23(44): 7899-7905
16. Ruane PJ, Ain D, Stryker R, Meshrekey R, Soliman M, Wolfe PR, Riad J, Mikhail S, Kersey K, Jiang D, Massetto B, Doehle B, Kirby BJ, Knox SJ, McHutchison JG, Symonds WT. Sofosbuvir plus ribavirin for the treatment of chronic genotype 4 hepatitis C virus infection in patients of Egyptian ancestry.J Hepatol. 2015 May;62(5):1040-6. doi: 10.1016/j.jhep.2014.10.044. Epub 2014 Nov 5.
17. Foster GR, Pianko S, Brown A, Forton D, Nahass RG, George J, Barnes E, Brainard DM, Massetto B, Lin M, Han B, McHutchison JG, Subramanian GM, Cooper C, Agarwal K1; BOSON Study Group Efficacy of sofosbuvir plus ribavirin with or without peginterferon-alfa in patients with hepatitis C virus genotype 3 infection and treatment-experienced patients with cirrhosis and hepatitis C virus genotype 2 infection. Gastroenterology. 2015 Nov;149(6):1462-70. doi: 10.1053/j.gastro.2015.07.043. Epub 2015 Aug 4
18. R. Villani, I. Donatiello, F. Barone, F. Cavallone, G. Fioravanti, F. Di Cosimo, F. Bellanti, F. Sollitto, G. Vendemiale, G. Serviddio Efficacy and safety of direct-acting antivirals in elderly with chronic hepatitis C: results from a retrospective cohort study JGG 2018;66:46-55
19. Charlton M, Everson GT2, Flamm SL3,Kumar P, 4Landis C5,BrownJr. RS6Fried MS,7 Terrault NA,8.O'Leary JG,9Vargas HE10Kuo A11Schiff E12Sulkowski MS13Gilroy R14Watt KD15Brown K16,Kwo P Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease Gastroenterology 2015;149:649–659
20. Yek C, de la Flor C, Marshall J, et al. Effectiveness of direct-acting antiviral therapy for hepatitis C in difficult-to-treat patients in a safety-net health system: a retrospective cohort study. BMC Med. 2017;15(1):204. Published 2017 Nov 20. doi:10.1186/s12916-017-0969-3
21. McCaughan GW, Thwaites PA, Roberts SK, Strasser SI, Mitchell J, Morales B, Mason S, Gow P, Wigg A, Tallis C, Jeffrey G, George J, Thompson AJ, Parker FC, Angus PW Sofosbuvir and daclatasvir therapy in patients with hepatitis C-related advanced decompensated liver disease (MELD ≥ 15). Aliment Pharmacol Ther. 2018 Feb;47(3):401-411. doi: 10.1111/apt.14404. Epub 2017 Dec 5.
22. Feng Su; Lauren A. Beste; Pamela K. Green; Kristin Berry; George N. Ioannou Direct-acting antivirals are effective for chronic hepatitis C treatment in elderly patients: a real-world study of 17 487 patients European Journal of Gastroenterology & Hepatology. 29(6):686–693, Jun 2017
23. Rachel Baden, Jürgen K. Rockstroh, Maria Buti Natural History and Management of Hepatitis C: Does Sex Play a Role? The Journal of Infectious Diseases 2014;209(S3):S81–5
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