Hepatitis C Clinical Trial
Official title:
Evaluation of the Clinical Effects of Ombitasvir/Paritaprevir/Ritonavir Regimen in the Treatment of Chronic HCV Patients in CKD Versus ESRD Patients in Assiut University Hospital
1. To asses curability of( Ombitasvir ,Paritaprevir,Ritonavir) in chronic HCV infected
patients in those with CKD versus ESRD in Assiut Hospital University .
2. Also assess duration of sustained viral response,treatment, relapse or failure of
therapy in CKD versus ESRD in Assiut Hospital.
Hepatitis C virus (HCV) is a leading cause of liver disease worldwide, as 130-170 million
individuals are chronically infected and 350,000 patients die every year from HCV infection.
The HCV prevalence varies widely among countries being highest in several African and Eastern
Mediterranean countries. So public health authorities should recognise the importance of HCV
and make resources available for the implementation of effective primary prevention,
screening and management policies .
The hepatitis C virus (HCV) genotype is an important predictor of disease progression and
treatment response. Genotype 1b has a worldwide distribution and is often found to be the
most common genotype. HCV-genotype 4 causes approximately 20% of the 180 million cases of
chronic hepatitis C in the world, is predominant in the Middle East and Northern Africa, and
has recently spread to Southern Europe. Genotype 4 accounts for more than 90% of the reported
cases from Egypt, a country with a massive HCV-related disease burden.
The prevalence of anti-hepatitis C virus Ab (anti-HCV) positivity among dialysis patients
varies across countries, ranging from 3 to 75%; unfortunately, Egypt is considered one of the
countries with the highest prevalence despite the existence of guidelines for a comprehensive
infection control program.
In Egypt In the 15-59-year age groups, the prevalence of HCV antibody was found to be 10.0%
and that of HCV RNA to be 7.0%. Approximately, 3.7 million persons have chronic HCV infection
in the age group 15-59 in 2015.
In the treatment of chronic HCV in renal impairment For patients with mild to moderate renal
impairment (CrCl 30 mL/min-80 mL/min), no dosage adjustment is required when using fixed-dose
combination of paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir (25 mg) .
Abbvie's 2D regimen (paritaprevir (150 mg)/ritonavir (100 mg)/ombitasvir(25mg)) was recently
approved with specific indication for genotype 4 treatment naïve and experienced patients
without cirrhosis achieved an sustained viral response rate of 100% following 12 weeks of 2D
regimen with RBV, 2D can be used without RBV but may have slightly lower SVR (91% vs 100%).
Currently, there is no FDA indication for 2D regimen use in patients with cirrhosis.
. Ombitasvir (25 mg once daily), Paritaprevir (150 mg once daily), Ritonavir (100 mg once
daily)Ribavirin (RBV): weight-based and divided bid (1000 mg/day if < 75kg or 1200 mg/day if
≥ 75kg) .
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