Treatment of Hepatitis C Cirrhotic Patients With Directly Acting Antivirals: A Multicenter Study

Abstract

Background &Aims: With the introduction of sofosbuvir based regimens, there have been achieved high cure rates and decreased duration. Several studies showed variances in SVR rates between different genotypes, with lower rates of SVR among cirrhotic patients . The aim of our study was to assess the safety and effectiveness of sofosbuvir-based antiviral regimens for the treatment of HCV-infected Egyptian cirrhotic patients. Methods: This was a retrospective observational comparative study. Nine hundred forty six cirrhotic patients with chronic HCV genotype 4 infection who were eligible for direct acting drugs (DAAs) therapy were enrolled. The primary outcome measures were the number of patients with successful eradication of the virus evidenced by SVR at 12 Weeks After discontinuation of therapy (SVR12) and the secondary outcome measures were the incidence of adverse effects associated with the tested HCV therapy. Results: Among the 946 patients enrolled in the study; 527 patients (55.7%) were males and 419 patients (44.3 %) were females with mean age 54.00±8.88 years. 20.2 % were diabetics and 19.1% were hypertensive. Patients were classified according to Child -Pugh classifications; 818 patients (86.46%) were Child-Pugh class A cirrhosis, 28 patients (13.53 %) were Child-Pugh class B cirrhosis. SVR12 rate was 96.93% (917 /946). Treatment response in the Child-Pugh class A cirrhosis was 794 (97%) after 12 weeks while treatment response in the Child-Pugh class B cirrhosis was 123 (96%). Mild side effects were observed in 76 patients. Conclusions: Sofosbuvir based regimens were effective and safe in the treatment of cirrhotic patients with chronic hepatitis C genotype 4.

Seroprevalence of hepatitis C virus infection in children: A systematic review and meta‐analysis

“…High-risk children are already under focus and screening for viral According to WHO, there were approximately 71 million people living with chronic HCV in 2015 with the highest prevalence in the eastern Mediterranean region (23%), followed by the European region (15%), and the African region (1%). [1][2][3][4][5][6][7][8][9][10][11] As a result, in some countries, the true prevalence of HCV in adolescents and children may be underestimated. According to data from the United States, HCV prevalence is rising in adolescents, who has been connected to the opioid epidemic and rising HCV infection rates among women of reproductive age.…”

“…HCV infection raises the risk of morbidity and mortality, and it is the major cause of end‐stage liver disease, cirrhosis and liver cancer in people all over the world 18–23 . Despite the fact that HCV infection seldom causes morbidity in children, the majority of HCV‐infected children develop chronic HCV, putting them at risk for life‐threatening liver disease 9–26 …”

“…HCV elimination techniques for children, on the other hand, have yet to be developed. [10][11][12][13][14][15][16][17][18][19][20][21] Estimates of paediatric prevalence are needed to aid in the scaling up of therapy and screening and testing approaches for this population. The prevalence of HCV in this unique community has not been adequately investigated.…”

“…[18][19][20][21][22][23] Despite the fact that HCV infection seldom causes morbidity in children, the majority of HCV-infected children develop chronic HCV, putting them at risk for life-threatening liver disease. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Furthermore, some research suggests that HCV has an impact on children's quality of life and behaviour, as cognitive function has been proven to be impaired, and families have reported greater levels of stress, both of which have a negative impact on family connections and well-being. [21][22][23][24][25][26][27] There are few statistics on the prevalence of HCV in children at the moment.…”

“…[21][22][23][24][25][26][27] There are few statistics on the prevalence of HCV in children at the moment. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The purpose of this study was to look at…”