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Treatment with a combination of the nucleotide polymerase inhibitor sofosbuvir and NS3A (non-structural protein 3A) protease
inhibitor simeprevir resulted in high rates of sustained virological response in chronic hepatitis C Genotype 4.
Methods: We conducted a real life study on Egyptian patients coming to tropical medicine department clinic at El Mery main
university hospital from February 2015 to February 2016 for treatment naïve and treatment experienced patients with chronic HCV
genotype 4, including cirrhotics and non cirrhotics. Naïve (cirrhotics and non cirrhotics) and relapsers (non cirrhotics) received
nucleotide polymerase inhibitor sofosbuvir and NS3A inhibitor simeprevir once daily for 12 weeks and 24 weeks for relapse cirrhotic
patients. The primary end point was a sustained virologic response at 12 weeks after end of treatment.
Results: 30 naïve patients with HCV genotype 4 and 20 relapsers (10 non cirrhotic and 10 cirrhotic patients) were enrolled. Cirrhosis
was diagnosed on ultrasound basis. Degree of fibrosis was confirmed by fibrotest in relapsers. Upon treatment of patients with
sofosbuvir and semiprevir once daily for 12 weeks and 24 weeks only to cirrhotic relapsers, end of treatment PCR was negative in
100% in all groups including cirrhotics and non cirrhotics. Primary end point (SVR 12) was achieved in 100% of all patients. Second
end point (SVR 24) was achieved in 96.6% of naïve patients; SVR 24 for non-cirrhotic relapsers was achieved in 100% of patients and
in 90% of cirrhotic relapsers. Rash and jaundice were noticed in one patient.
Conclusions: Once daily sofosbuvir and simeprevir for 12 weeks provided high rate of sustained virological response among treatment
naïve and treatment experienced patients with HCV genotype IV.
Marwa Ibrahim was graduated from Faculty of medicine from Alexandria University, Egypt as Medical Doctor 2005, with the specialties including Tropical Medicine, Hepatology, gastroenterology and infectious diseases with 3 years of residency in Alexandria main university hospitals as an intern of tropical medicine gastroenterology and hepatology and Master degree in tropical medicine from the University of Alexandria 2010. Later on she worked as an assistant lecturer of Tropical medicine, Faculty of Medicine, Alexandria University Egypt 2010-2014 till she obtained her MD from University of Alexandria in non-surgical treatments of hepatocellular carcinoma and then started working as a Lecturer of Tropical Medicine, Alexandria University, faculty of medicine, Egypt 2014-till now as well as University co-supervisor on fever hospital center for treatment of hepatitis C, where she has continued her research.