Retrospective analysis of direct acting antiviral therapy in patients with chronic hepatitis c at Bursa Uludağ University Medical Faculty between in the years of 2016-2018

Pegylated interferon (Peg-IFN) and ribavirin (RBV) have been used for many years in the treatment of chronic hepatitis C (CHC) infection. Recently, CHC has led to the development of new direct acting antiviral agents (DAA) and the achievement of sustained virologic response (SVR) in excess of 95%. The aim of our study is to investigate the efficacy and safety of the treatment regimens for CHC with paritaprevir/ritonavir/ ombitasvir±dasabuvir (PTV/RTV/OBV±DSV) and sofosbuvir±ledipasvir (SOF±LDP) with or without RBV, in our clinic. Patients who get PTV/RTV/OBV±DSV or SOF±LDP treatments in the Department of Infectious Diseases and Gastroenterology of Bursa Uludağ University Medical Faculty between in the years of 2016-2018 were included in our study. Demographic datas of the cases; biochemical and molecular parameters before, during and after the treatment and drug side effects were examined. 12 and 24 weeks after the treatments finalized, treatment responses were compared according to treatment regimens and HCV genotypes. A total of 223 cases (94 female, 129 male) were included in the study. The median age of the patients was 62±14 (20-84) years. There were 19 patients with hepatocellular cancer, 14 patients with liver transplantation, 18 patients with chronic renal failure and 3 patients with kidney transplantation. 173 (77,6%) of the cases were genotype 1-1b, 19 (8,5%) genotype 1, 17 (7,6%) genotype 3, 9 (4%) genotype 1-1a, 4 (1,8%) were genotype 4 and 1 (0,4) were genotype 2. There were 103 (46%) cases with Peg-IFN±RBV±Protease Inhibitor experiences prior to DAA treatment and 120 (54%) cases were naive. 63 (28%) of the cases were cirrhotic and 160 (72%) were nonsirotic. 116 (52%) cases got SOF±LDP±RBV regimen; PTV/RTV/OBV±DSV±RBV regimen was given to 107 (48%) patients. 12 weeks after treatment HCV-RNA was negative in 153 (94,4%) of 161 patients. In 8 (4,9%) patients, there was no sustained virologic response (SVR12) on the 12th week. One naive patient with genotype 1-1b which also had compensated cirrhosis showed exacerbation with PTV/RTV/OBV±DSV regimen during the treatment, also, there was no respend to treatment in a naive, genotype 1-1b paient who didn't use the medications regularly. One naive, nonsirotic patient with genotype 1-1b was HCV-RNA positive at the 24th week with PTV/RTV/OBV±DSV regimen. Patients with genotype 1-1b were found to have higher SVR12 rates than the other genotypes (p = 0,009). There was no significant corelations for SVR12 between sex, age, cirrhosis, treatment experience in all genotypes and treatment groups (p = 0,486; p = 0,985; p = 0,232; p = 0,737 respectively). Side effects were seen in 34 (15%) of the cases. The most common side effect was weakness (8%), secondly itchiness and abdominal pain (2%). Only 1,3% patients were discontinued the treatment because of the side effects. We find that SVR12 rates were higher in patients with genotype 1-1b than other genotypes with DAA treatments for CHC. PTV/RTV/OBV±DSV and SOF±LDP are effective and reliable, and have high rates of SVR12.