Outcome of Sofosbuvir containing Treatment Regimens in Egyptian Chronic Hepatitis C Patients with Thrombocytopenia

Introduction chronic HCV patients with thrombocytopenia have difficulty in initiating or maintaining therapy with potential for progression of liver disease if treatment is postponed. Objectives to evaluate impact of thrombocytopenia on the outcome of 2 sofosbuvir containing regimens used in Egypt for treatment of chronic hepatitis C patients. Material and methods a prospective cohort study included 260 chronic HCV patients stratified into 2 groups, group I included 60 patients with platelet count ?150, 000/mm3 as a disease control and group II (thrombocytopenia group) included 200 patients with platelet count ranged from 30, 000- 149, 000/mm3 which was sub grouped according to severity of thrombocytopenia into A and B. Patients were subjected to dual or triple therapy according to criteria for interferon illegibility or ineligibility recommended by national committee for chronic viral hepatitis (NCCVH), 2014. Results sustained virological response and relapse in patients with thrombocytopenia didn't significantly differ from normal platelets patients and didn't differ significantly between thrombocytopenic patients received triple or dual therapy. Cirrhotics and advanced Child's score had significantly lower sustained virological response (p = 0.03& 0.001) in these patients. Complications during and after termination of therapy didn't significantly differ from patients with normal platelets. Significant improvement of thrombocytopenia was achieved following the course of dual therapy. Conclusion thrombocytopenia had no impact on decreasing sustained virological response or increasing relapse with these sofosbuvir regimens. Cirrhosis and advanced Child's score are significant factors in decreasing the rate of sustained response in these patients. Further studies are needed in patients with thrombocytopenia in the era of newly developed directly acting antiviral drugs especially in cirrhotic and treatment experienced.