HCV Clinical Trial
Official title:
Safety of Sofosbuvir Plus Daclatasvir in Patients With Chronic Hepatitis c Virus and Assessment of Resistance Associated Variants in Resistant and Relapsed Cases
To identify side effects of Sofosbuvir/ Daclatasvir treatment regimen of chronic HCV GT-4
infection.
- To assess the occurrence and the prevalence of RAVs in patients with treatment failure
and relapse after sofosbuvir and daclatasvir with assessment of their types .
- To examine the GT4 subtypes by phylogenetic analysis and baseline sequence variability
among subtypes and their potential impact on treatment outcome and development of viral
resistance in patients who received a regimen of Sofosbuvir/ Daclatasvir for treatment
of chronic HCV GT-4.
- To assess the differences in patient demographics across GT4 subtypes.
Hepatitis C virus (HCV) chronically infects approximately 120-130 million individuals
worldwide .Mortality related to HCV infection has been estimated at approximately 300,000
deaths per year..
Direct antiviral agents (DAAs) effectively eradicate HCV and rapidly improve residual liver
functions. Current HCV eradication rates have exceeded 90% in a very short time .
Hepatitis C virus genotype 4 (GT4) is genetically diverse, with 17 confirmed subtypes, and
comprises approximately 13% of infections worldwide [3]. In Egypt, GT4 accounts for
approximately 90% of infections, with subtype 4a predominating .
Sofosbuvir and daclatasvir are generally well tolerated with only a few adverse effects
reported.
Hepatitis C virus resistant associated variants (RAVs) are seen in most patients who do not
achieve sustained virological response (SVR). These resistance-associated mutations depend on
the class of direct-acting antiviral drugs used and also vary between hepatitis C virus
genotypes and subtypes.
Donaldson et al performed an analysis on four phase III clinical trials in search of common
RAVs against sofosbuvir, discovering L159F, C316N, and V321A were associated with virological
failure. Interestingly, this study also verified S282R mutation as associating with failure.
NS5A RAVs can be very common, with Y93H detected in up to 15% of the population and L31M in
up to 6.3%. Other RAVs tend to also be fairly common detected in approximately 0.3%-3.5% of
the population
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