Genotype 4 is the least studied of the hepatitis C virus (HCV) variants and until recently has been considered difficult to treat because conventional interferon monotherapy has resulted in disappointing virologic responses. However, recent reports show that a combination therapy with pegylated interferon-α (PEG-IFN-α) and ribavirin markedly improves treatment outcomes, resulting in a sustained virologic response (SVR) in 44–69% of cases.
Sofosbuvir (SOF) is a pyrimidine nucleotide analogue that inhibits HCV NS5B RNA-dependent RNA polymerase that is essential for viral replication and is relatively conserved across HCV genotypes and HCV quasispecies. Thus, SOF has pangenotypic activity and provides a high barrier to resistance. SOF in combination with ribavirin with or without PEG-IFN-α and in combination with other anti HCV DAAs leads to high response rates in the treatment of hepatitis C.
The aim of this work is to evaluate SOF in combination with ribavirin with or without PEG-IFN-α for the treatment of Egyptian patients with hepatitis C infection (genotype 4).
Patients and methods
This study included a total of consecutive 100 patients with HCV (50 patients on dual therapy with SOF and ribavirin for a 6-month duration and 50 patients on triple therapy with SOF, ribavirin, and interferon for a 3-month duration).
This study showed that 80% (40/50) of patients who received triple therapy achieved an SVR, whereas 72% (36/50) of patients who received dual therapy achieved an SVR.
Use of PEG-IFN-α with ribavirin and SOF increases the SVR more than the use of both drugs alone.