SOFOSBUVIR-VELPATASVIR THERAPY IN THE TREATMENT OF CHRONIC HEPATITIS C GENOTYPE 3

Abstract

Objective: To determine the efficacy and safety of sofosbuvir-velpatasvir combination therapy in treatment of
chronic hepatitis C genotype 3.

Study Design: Prospective cohort study.

Place and Duration of Study: Department of Medicine, Combined Military Hospital Lahore, from Mar 2018 to
Oct 2019.

Methodology: Eighty eight consecutive patients, who were ≥18 years of age with chronic hepatitis C as confirmed by polymerase chain reaction were included in the study. Primary end point was sustained virological response at 12 week post-treatment. Patients with any of the following criteria at presentation were excluded from study: aspartate/alanine aminotransferase >10 times the upper limit of normal, total bilirubin twice the upper limit of normal, haemoglobin <8g/dL, platelet count <30,000/uL, albumin <2 g/dL and creatinine clearance of <60 mL/ min. Additional criteria for exclusion included patients who had co-infection with hepatitis B or human immune deficiency virus (HIV), significant cardiac or lung disease, porphyria, liver cirrhosis caused by non-HCV related causes or co-existent hepatocellular carcinoma.

Results: Overall sustained virological response was achieved in 82 of 84 patients (97.6%). One of the patients with genotype 3 had detectable HCV RNA at end of treatment, which became undetectable at 12 weeks, post-treatment. 38 /38 (100%) patients without cirrhosis while 41/43 patients (95.3%) with compensated cirrhosis and 3/3 with decompensated cirrhosis achieved sustained virological response. Two (2.3%) patients had on-treatment virological failure. Four patients were lost to follow up.

Conclusion: Treatment with sofosbuvir and velpatasvir is effective and well tolerated in patients with chronic
hepatitis C, genotype 3.