Sofosbuvir plus ribavirin for the treatment of chronic genotype 4 hepatitis C virus infection in patients of Egyptian ancestry

J Hepatol. 2015 May;62(5):1040-6. doi: 10.1016/j.jhep.2014.10.044. Epub 2014 Nov 5.

Abstract

Background & aims: We conducted an open-label phase 2 study to assess the efficacy and safety of the oral nucleotide polymerase inhibitor sofosbuvir in combination with ribavirin in patients of Egyptian ancestry, chronically infected with genotype 4 hepatitis C virus (HCV).

Methods: Treatment-naive and previously treated patients with genotype 4 HCV were randomly allocated in a 1:1 ratio to receive sofosbuvir 400mg and weight-based ribavirin, for 12 or 24 weeks. The primary efficacy endpoint was the proportion of patients with sustained virologic response (HCV RNA <25IU/ml) 12 weeks after cessation of therapy (SVR12).

Results: Thirty treatment-naive and thirty previously treated patients were enrolled and treated for 12 weeks (n=31) or 24 weeks (n=29). Overall, 23% of patients had cirrhosis and 38% had diabetes. 14% of treatment-naive patients were interferon ineligible and 63% of treatment-experienced patients had prior non-response. SVR12 was achieved by 68% of patients (95% CI, 49-83%) in the 12-week group, and by 93% of patients (95% CI, 77-99%) in the 24-week group. The most common adverse events were headache, insomnia, and fatigue. No patient discontinued treatment due to an adverse event.

Conclusions: The findings from the present study suggest that 24 weeks of sofosbuvir plus ribavirin is an efficacious and well tolerated treatment in patients with HCV genotype 4 infection.

Keywords: Direct-acting antiviral; Egyptian; Genotype 4; Hepatitis C virus; Interferon-free therapy; Sofosbuvir.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects
  • Drug Therapy, Combination / methods
  • Egypt
  • Female
  • Hepacivirus* / drug effects
  • Hepacivirus* / genetics
  • Hepatitis C, Chronic* / drug therapy
  • Hepatitis C, Chronic* / ethnology
  • Hepatitis C, Chronic* / virology
  • Humans
  • Male
  • Middle Aged
  • RNA, Viral / analysis
  • RNA-Dependent RNA Polymerase / antagonists & inhibitors
  • Ribavirin* / administration & dosage
  • Ribavirin* / adverse effects
  • Sofosbuvir* / administration & dosage
  • Sofosbuvir* / adverse effects
  • Treatment Outcome
  • United States
  • Viral Load / drug effects
  • Viral Load / methods
  • Viral Nonstructural Proteins / antagonists & inhibitors

Substances

  • Antiviral Agents
  • RNA, Viral
  • Viral Nonstructural Proteins
  • Ribavirin
  • NS-5 protein, hepatitis C virus
  • RNA-Dependent RNA Polymerase
  • Sofosbuvir