Virologic response following combined daclatasvir and sofosbuvir administration in patients with HCV and HIV co-infection / Ahmed Abdelmonem Mohamed Cordie Abdelhamid ; Supervised Gamal Eldin Esmat Mohamed Gamil , Aisha Mahmoud Elsharkawy , Safa Sayed Mashaal

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

Background: Hepatitis C virus {uFD3E}HCV{uFD3F} co{u2010}infection among people living with human immunodeficiency virus {uFD3E}PLHIV{uFD3F} is a growing worldwide health burden. Genotype 4 accounts for more than 90% of existing HCV in Egypt. Although treatment of hepatitis C genotype 4 has become very effective in Egypt, there is no data about safety and efficacy of used direct acting antiviral agents (DAAs) in HCV co-infected PLHIV. Aim of work: To demonstrate SVR rate, side effects profile, immunologic response and HIV suppression state after using the combination of daclatasvir and sofosbuvir for treating 50 HIV/HCV co-infected patients. Patients and methods: In this cohort study, 50 eligible patients with confirmed genotype 4 HCV/HIV co-infection were enrolled between November 2015 and June 2017 to recieve HCV treatment (12 weeks of daclatasvir 60 mg daily with dose adjustment for concomitant antiretroviral medications if any, plus 400 mg of sofosbuvir daily). Serial measurements of safety parameters, virologic and host immune correlates, and adherence were performed during treatment and 12 weeeks after treatment. Results: Overall, 47 patients achieved sustained virological response at week 4 post treatment (SVR 4) (94%) and 44 patients at week 12 (SVR 12) (88%). In the per protocol population, the SVR 4 and SVR 12 were (47/48, 97.9%) and (44/47, 93.6%) respectively. The most common adverse events were fatigue (32%), headache (20%). No patient discontinued treatment because of adverse events. No serious adverse events or mortality were reported. No alteration of HIV suppression was determined

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