Chronic Hepatitis C (HCV) is a deadly infection affecting > 185 million people worldwide and led to liver cirrhosis, hepatocellular carcinoma, or liver failure. Recently, treatment regimens of chronic HCV have entered the era of direct acting anti-virals (DAAs). Sustained virological response (SVR) rate is one of the best available tools to evaluate the efficacy of DAA treatments. Objective: To compare SVR rate and safety of two combinations of DAA treatments (Sofosbuvir and Daclatasvir vs Sofosbuvir and Velpatasvir) in chronic HCV infected patients of Lahore, Pakistan. Methods: Present randomized controlled trial was conducted at Mayo Hospital, Lahore, Pakistan and recruited 76 chronic HCV infected patients according to Consort guidelines. Registered patients were allocated in two groups by lottery method. Group A received sofobuvir with daclatasvir (SOFO + DCV) while group B received sofobuvir with velpatasvir (SOFO + VEL) treatment for 12 weeks. Response to therapy was evaluated in terms of SVR after 24 weeks and safety profile of the drug. Results: Both treatment groups showed high SVR 24 weeks after the completion of therapy. Group A (SOFO + DCV) presented 92% SVR while group B showed 97% SVR rate. Both DAA combination therapies presented good efficacy and safety profile. Few contraindications noted during the treatment included fatigue, arthritis, headache, loss of appetite and anemia. Conclusions: The efficacy of both DAA combination therapies was comparably high with > 90% SVR rate. Group A proved safer as compared to group B. Studied DAA combinations are effective treatment options for chronic HCV treatment planning.

Aim: To compare Impairment of pulmonary function tests due to plain versus pegylated interferon therapy in the diagnosed cases of chronic Hepatitis C Methodology: In this comparative study, 71 patients fulfilling inclusion criteria were randomly included in each group. Study consisted; Group 1 (Control Group): Pulmonary Function Tests performed before and after the completion of 24 weeks of treatment with Plain/conventional Interferons and ribavirin. Group 2 (experimental Group): PFTs performed before and after the completion of 24 weeks treatment with Pegylated Interferon Therapy and ribavirin. Referred patients of both groups underwent spirometry (PFTs) at baseline and at the end of 6 months Results: Mean value observed for age was 49.86, for height 1.592 meters, for weight 62.6 kg and for BMI 24.9. Before and after therapy mean for FEV1 was 90.19 and 67.71 and it was 91.34 and 67.83 for FVC respectively. N=71 patients were enrolled in both groups. Male gender showed high prevalence 70%. Group-1 (46 vs 25) & group-2 (45 vs 26) male to female ratio seen. Adult age group hold bulk of disease (30 - 40 years of age). Patients preferred winter season for treatment (Sep to Nov). Low viral load and genotype 3a were common findings (82% and 35%). Constitutional symptoms improved after therapy (86 to 44%) as a whole. Individually, anorexia, body aches, lethargy and fever were like this (39 vs 19%, 66 vs 28%, 54 vs 30%, 19 vs 11%) pre and post therapy. Cough and dyspnea reported in 7% and 20% respectively. Conclusion: According to the present study, treatment with pegylated interferon and ribavirin is associated with impairment of pulmonary function tests similarly as treatment with plain interferon and ribavirin. Long Half-life of pegylated interferon cause more impairment in lung functions as indicated by limited available literature (Foster GR et al). Keywords: Chronic hepatitis C, Pulmonary function tests, plain/Conventional interferon therapy, Pegylated interferon therapy.