Background and study aim: Major changes have emerged during the last few years in the treatment of chronic HCV infection. Several direct acting antiviral agents (DAAs) have been developed showing potent activity with higher rates of sustained virological response. This study shows comparison between triple therapy regimen (Peginterferon/ Ribavirin/ Sofosbuvir) and dual therapy regimen (Simprevir/Sofosbuvir) concerning efficacy and safety for Egyptian patients with chronic HCV infection.
Patients and Methods: This retrospective comparative study included 500 Egyptian patients with chronic HCV infection, randomly selected from Beni-Suef centre of treatment of viral hepatitis affiliated to the National committee for control of viral hepatitis (NCCVH). They were classified into two groups; triple therapy group included 250 patients had received pegylated interferon alpha, ribavirin and sofosbuvir for 12 weeks and dual therapy group included 250 patients had received sofosbuvir and simeprevir for 12 weeks. All patients were monitored for treatment safety and efficacy.
Results: In the triple therapy group, mostly observed clinical side effects were; flu like illness (40% of patients), GI manifestations (20.8% of patients) and psychological manifestations (10.4% of patients) while photosensitivity (22% of patients), flu like illness (18.8% of patients) and GI manifestations (4.8% of patients) were the most frequently occurring clinical adverse effects in dual therapy group. Anemia (62.4% of patients) and leucopenia (49.6% of patients) were the mostly observed hematological abnormalities in triple therapy group while hyperbilirubinemia (38% of patients) was the mainly observed biochemical abnormality in dual therapy group. In the triple therapy group, the end of treatment response (ETR) rate was 95.6% while sustained virological response (SVR) rate was 91.2%. In dual therapy group, ETR rate was 95.6 % while SVR rate was 93.6 %.
Conclusion: The dual therapy (Simeprevir and Sofosbuvir) regimen is more tolerated than triple therapy (Peginterferon, Ribavirin and Sofosbuvir) regimen for Egyptian patients with chronic HCV infection. There was no statistically significant difference as regard sustained virological response between both triple therapy and dual therapy regimens.