New regimens involving direct-acting antiviral agents have recently been approved for the treatment of genotype 4 HCV. Our aim was to assess the efficacy and safety of 12 or 24 weeks of Sofosbuvir plus ribavirin in treating patients with chronic genotype 4 hepatitis C virus infection. This is an open-label observational study that describes the effect of 12 week or 24 weeks of daily oral Sofosbuvir 400 mg and ribavirin 1000-12000 mg with dose adjustment if indicated. It includes the first 813 patients that fulfil the inclusion and exclusion criteria and treated in Egyptian Liver Research
Institute and Hospital (ELRIAH), Mansoura, Egypt. By week 4 of therapy 100% of patients had undetectable HCV RNA and all maintained virological suppression during therapy. SVR12 was achieved by 113 (77.4%) of the patients receiving 12 weeks of treatment, and by 622 (93.3%) of the patients receiving 24 weeks of treatment. SVR12 rates were significantly higher in patients with no cirrhosis, (86.3% for 12 weeks and 95.5% for 24 weeks) than in patients with cirrhosis (56.8% for 12 weeks and 87.0% for 24 weeks). The most common adverse events in both groups were anemia, headache, epigastric pain, insomnia, and heart burn. No serious adverse events were reported in the studied groups. No adverse events resulted in interruption of RBV. No patients had adverse events leading to dose modification or discontinuation of sofosbuvir. Treatment with Sofosbuvir and ribavirin for 12 or 24 weeks was effective and well tolerated in patients with genotype 4 HCV.