Efficacy and safety of sofosbuvir and daclatasvir with or without ribavirin in elderly patients with chronic hepatitis C virus infection

Abstract

Hepatitis C virus (HCV) infection is considered as a major public health problem that, worldwide, chronically affects 170 million people. Elderly patients are more likely than younger patients to have increased duration of infection, increased rate of disease progression, and subsequently increased incidence of advanced liver disease. Natural history models predicted that the prevalence of HCV infection and its chronic sequelae as well as extrahepatic manifestations will eventually increase through the next decade and will mostly affect those who are greater than 60 years of age. Moreover, polytherapy and polypharmacy are frequent in elderly patients due to associated comorbidities. As advanced age is associated with increasing risk of development of cirrhosis and hepatocellular carcinoma, elderly patients are in special need of safe and effective antiviral therapies. Achievement of sustained viral responses (SVR) is associated with reduced liver-related complications and overall mortality in such patients with the advanced liver disease. With the recent introduction of interferon-free direct-acting antivirals, successful treatment for chronic HCV infection had dramatically improved, with overall cure rates that exceed 90% SVR. In our study, we aimed to study the efficacy and safety of combined sofosbuvir and daclatasvir, with or without ribavirin, in management of chronically infected HCV elderly patients who are more than 60 years old.

On-Treatment Improvement of an Emerging Psychosomatic Depressive Disorder Among Salmonella Carriers: A Multicenter Experience from Egypt

“…42,45 Many infectious agents have been suspected as risk factors for depression, including hepatitis C virus, enterovirus, herpes simplex 1, Epstein-Barr virus, human immunodeficiency virus, varicella-zoster virus, human T-cell lymphotropic virus, Borna disease virus, brucellosis, and Chlamydophila trachomatis. [46][47][48][49][50][51][52] A recent study from Egypt reported that patients treated for chronic hepatitis C decompensated liver cirrhosis using new direct-acting antiviral drugs, which in turn, showed an improvement in liver tests and health-related quality of life. However, longer duration of follow-up for decompensation events are essential.…”

<p>The Circulating Micro-RNAs (−122, −34a and −99a) as Predictive Biomarkers for Non-Alcoholic Fatty Liver Diseases</p>

“…Mi-RNAs, short, non-coding RNAs that regulate gene expression, have been associated with histological features of NAFLD and are readily detected in the circulation. [31][32][33][34][35] The current study showed a significant increase in the level of mi-RNA-122 in NAFLD patients compared to controls, and its level is associated with disease severity from simple steatosis to steatohepatitis. This finding is in agreement with Jampoka et al, 36 who found that serum mi-RNA-122 levels in NAFLD patients were significantly higher than those found in the control group.…”

Sudomotor Changes in Hepatitis C Virus Infection with or without Diabetes Mellitus: A Pilot Study in Egyptian Patients

“…Hepatitis C virus infection is a major cause of liver disease in all Egyptian areas, [24][25][26] representing the highest prevalence in the world with about 10% of the population, [27][28][29] the natural history of HCV infection is affected by viral and host factors. 30,31 Hepatitis C virus infection is associated with neuropsychiatric disorders in about 50% of patients and can cause a wide variety of PN, including mainly SFSN and less frequent large LFSN.…”