Efficacy of Direct-Acting Antiviral in Treatment-Naive Chronic HCV Patients and in Those Previously Treated with Interferon and Ribavirin
Efficacy of Direct-Acting Antiviral in Treatment-Naive Chronic HCV Patients and in Those Previously Treated with Interferon and Ribavirin
Saima Younas1*, Quratulain Maqsood1, Aleena Sumrin1, Muhammad Umer Khan2 and Nazim Hussain1
ABSTRACT
Pakistan has been ranked second highest in prevalence of hepatits C virus (HCV), all over the world. HCV genome depicts huge genetic variability resulting in seven different HCV genotypes (GTs) including around 90 sub types. Direct acting antivirals had revolutionized HCV treatment with less side effects and higher sustained virological response rate (SVR). For achievement of better SVR, Pakistan National HCV treatment guidelines include the use of DAAs, sofosbuvir (SOF) and daclatasvir (DCV). Current study was designed to analyze treatment efficacy of two different DAA-based regimens in chronic HCV infected people among most recurrent genotypes (GT) of HCV in the patients employing DAAs for the first time (HCV treatment-naive) and in the patients those already experienced interferon (INF) plus ribavirin (RBV) combined treatment (HCV treatment-experienced).For this purpose blood samples were collected from patients positive for anti-HCV antibodies, processed for RNA isolation, detection and quantification of HCV RNA, followed by GT determination. Treatment response rate was determined in terms of end treatment response rate (ETR) and sustained virological response rate (SVR) at end of treatment and 12 weeks after completion of treatment respectively. 88.8% patients were found detected for HCV RNA, with 53.1% males, mean age 44.86 + 13.19, and mean viral load of 6.68 +1.8. HCV GT-3a was found to be most common as 87.3, while GT-1a was found as 9.9%, GT-3a/3b as 2.80%, and 7.8% were typable. For SOF+RBV, overall ETR against studied GTs was 88.9%, SVR was 85.4%, while for SOF+DCV ETR recorded was 92% and SVR was 88.8%.
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