الفهرس | Only 14 pages are availabe for public view |
Abstract Hepatitis C virus (HCV) accounts for a sizable proportion of cases of chronic liver disease, liver disease deaths and cases of hepatocellular carcinoma and represents the most common indication for liver transplantation ,approximately 3% of the world’s population (roughly 170-200 million people) infected with hepatitis C virus with considerable regional variations , In egypt, The seroprevalence in the age groups 15–59 years was 10% (compared to 14.7% in the 2008 DHS).. HCV is currently the most significant public health problem in Egypt Patients with cirrhosis should be treated when possible for the underlying liver disease to stop disease progression.The goal of treatment in chronic HCV infection is to achieve virological cure, thereby reducing all-cause mortality and liver-related health adverse consequences, including end-stage liver disease and HCC.The aim of the Study is to detect the Efficacy and safety of direct antiviral agents in treatment of compensated cirrhotic naïve patients due to chronic HCV infection. This study was conducted on (300) patients with chronic HCV who attended El-fayoum general hospital , who received therapy, from January 2015 to June 2016. Patients were distributed on four groups of treatment regimens each group incuded 75 patients ,group (I) received "Sofosbuvir & Ribavirin ", group (II) received " Sofosbuvir & Ribavirin & Interferon", group (III) received " Sofosbuvir & Simeprevir ", and group (IV) received " Sofosbuvir & Ribavirin & Daclatasvir", they were naïve to treatment. All patients were subjected to clinical assessment, laboratory investigations, and followed up fo 12 weeks and had PCR for HCV to detect treatment response .only 3 patients didn’t contiue follow up schedule (N.B, from group one,two patients had hematemsis and died before follow up PCR result also one patient didn’t continue treatment for unknown cause ) Our study noticed the incidence of some adverse effects during treatment that were mild to moderate and didn’t affect completion of treatment as (Anemia ,Fatigue ,Photosensitivity ,Weight loss ,Thrombocytopenia ,Itching ,Headache and Herpes zoster) except 2 patients had hematemesis and died after end of treatment before testing for SVR , In group 1 anemia 11(14.7%) ,fatigue4(5.3%) photosensitivity1(1.3%) ,weight loss 3(4%) , thrombocytopenia 1(1.3%),itching1(1.3%) , headache 6(8%),herpes zoster 1(1.3%). In group 2 anemia6(8%), fatigue 8(10.7%) , weight loss 4(5.3%), thrombocytopenia5(6.7%) ,itching 3(4%), headache 4(5.3%), In group 3 anemia 3(4%),fatigue 3(4%), photosensitivity3(4%) ,weight loss3(4%), headache 3(4%),. In group 4 anemia 8(10.7%),fatigue 6(8%),weight loss3(4%) , headache 7(9.3%). According to treatment response (patients achieve SVR ,12 weeks after end of treatment ), in group 1 patients achieved SVR 53(70.7%),and those didn’t were 2 died before confirming treatment response 2(2.6%) and 1 patient missed during therapy 1(1.3%) and relapsed 19(25.3%), in group 2 patients achieved SVR 63(84%) and relapsed 12(16%), in group 3patients achieved SVR 69(92%) and relapsed 6(8%), in group 4 patients achieved SVR 68(90.7%) and relapsed 7(9.3%). Our results revealed that DAAs are safe and effective in treatment of patients infected with HCV and had compensated liver cirrhosis with better results in whom treated with" Sofosbuvir & Simeprevir " or " Sofosbuvir & Ribavirin & Daclatasvir" than whom received "Sofosbuvir & Ribavirin ", or " Sofosbuvir & Ribavirin & Interferon" regimens. |