Treatment Efficacy of Sofosbuvir Containing Regimes in Chronic Hepatitis C, Genotype-3 Infected Patients in Indian Population - A Real World Experience

Background: Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. Chronic hepatitis C and its complications impose a substantial burden on affected patients, healthcare systems and society. The introduction of direct acting antiviral agents, in particular sofosbuvir (SOF), has revolutionized the treatment for chronic hepatitis C virus. With SOF-based regimens, we have achieved high cure rates, decreased the duration of treatment and IFN-free treatment regimens have been made possible. AIMS AND OBJECTIVES To assess the treatment efficacy of sofosbuvir containing regimens in chronic hepatitis C infected patients of genotype 3 in Indian population. MATERIALS AND METHODS All the consecutive chronic hepatitis C, genotype 3 infected patients from outpatient and inpatient departments, fulfilling the inclusion and exclusion criteria were enrolled in the study. A total of 69 patients were included in study. Patients were divided into two groups. Those who received 24 weeks of Sofosbuvir plus Ribavirin (SR) belonged to group A with 39 patients, while those who received 12 weeks of Sofosbuvir plus Ribavirin plus peg interferon (SPR) belonged to group B with total of 30 patients. Patients were monitored by clinical and standard laboratory tests on follow up visit to OPD. HCV RNA was measured at baseline, 4 week and at the end of treatment. After the completion of treatment protocol, these patients were followed for further 12 weeks and then quantitative HCV RNA level was done to check SVR12. Results: The overall sustained virological response at 12 weeks (SVR12) was achieved in 87.2 % in group A (SR). In cirrhotic patients SVR12 was achieved only in 66.7 % while in non cirrhotic patients 93.3 % have achieved SVR12. The overall sustained virological response at 12 weeks (SVR12) was achieved 90 % in group B (SPR). In cirrhotic patients SVR12 was achieved 70 % patients while all non cirrhotic 100 % patients have achieved SVR12. Conclusion: Triple drug regimen (Sofosbuvir, Pegylated Interferon and Ribavirin) had showed a better overall treatment response than the dual regimen (Sofosbuvir and Ribavirin). Triple drug therapy could be still preferred in selected patients who are Interferon eligible with genotype 3 Hepatitis C related compensated Cirrhosis in our Indian population. The overall treatment response was relatively lower in cirrhotic patients.