Sofosbuvir Plus Daclatasvir With or Without Ribavirin and Chronic HCV Genotype (GT) 4

Egyptian participants infected with HCV GT4 were classified into two groups: group 1 (easy to treat) was treated with a dual therapy of SOF/DCV daily for 12 weeks and group 2 (difficult to treat) was treated with a triple therapy of SOF/DCV/RBV daily for 12 weeks.

SOF dose was 400 mg/day given orally DCV was given in a dose of 60 mg/day, orally. RBV was given as oral tablets in the morning and in the evening based on patient's weight and tolerability (starting dose 600 mg/day to reach 1200 mg/day.

Inclusion criteria

• Non-cirrhotic treatment-naïve participants
• FIB-4 < 3.25
• albumin > 3.5
• total bilirubin < 1.2 mg/dl
• international normalized ratio (INR) < 1.2
• platelet count > 150,000 mm3.
• experienced participants who had previously failed treatment with peg-IFN-α-/RBV, SOF/peg-IFN-α +RBV, or SOF/SMV
• Naïve cirrhotic participants were confirmed by ultrasonographic features of cirrhosis

Exclusion criteria

• liver disease of non-HCV etiology
• hepatitis B or human immune-deficiency virus (HIV) infection
• poorly controlled diabetic (HbA1C > 9) participants
• hepatocellular carcinoma
• a history of extra-hepatic malignancy within 5 years prior to the study
• pregnant or breast feeding
• renal disease; serum creatinine > 2.5 mg/dl or eGFR < 30 ml/min
• evidence of hepatic decompensation; INR > 1.7, serum albumin < 2.8 g/dl, total bilirubin > 3 mg/dl
• blood picture abnormalities such as anemia (hemoglobin concentration of 10 g/dl or less) and thrombocytopenia (platelet count < 50,000 cells/mm3)
• major severe illnesses such as congestive heart failure and respiratory failure.