Efficacy of sofosbuvir in interferon treated patients of hepatitis C infected with 3a genotype.

Abstract

Objectives: Hepatitis C is a blood borne infection primarily disrupting the functional and architectural integrity of liver and has a considerable share in worldwide mortality and morbidity. Treatment strategies against the causative RNA-based virus has widely evolved over time with newer Direct Acting Antivirals (DAA) being recently introduced. This study serves to assess the efficacy of Sofosbuvir (DAA) in patients of HCV genotype 3a with prior treatment with interferon. Study Design: An Open label, Prospective Quasi Experimental Study. Setting: Mayo Hospital, Lahore. Period: September 2016 to December 2017. Material and Methods: 212 patients with genotype 3a who had been previously treated with interferon (INF). They were treated with Sofosbuvir 400mg once daily and Ribavirin 400mg thrice daily. The treatment duration was 24 weeks following which the end of treatment response (ETR) was determined by quantifying viral load by Polymerase Chain Reaction (PCR). Results: Of the 212 patients enrolled, 50 patients did not give follow up either due to availability issues or due to non-compliance. 13 patients left the treatment due to comorbidities. 149 patients completed the treatment out of whom 131 patients showed positive response (87.9%). Nine patients with high viral load showed relapse while nine patients were non-responders. Conclusion: In interferon experienced patients of HCV genotype 3a, Sofosbuvir has shown to reach sublimecure rates which may serve to obviate conventional treatment strategies owing to their longer treatment duration and significant adverse effects. As demonstrated by this study, the modest safety profile coupled with an enhanced therapeutic efficacy of Sofosbuvir is expected to revolutionize treatment strategies against Hepatitis C limiting the spread and hence the incidence of disease.