Qualitative versus quantitative PCR in establishing response to chronic hepatitis C treatment with sofosbuvir

Objective: To determine the change in rapid virological response for chronic hepatitis C by qualitative PCR testing after treatment with sofosbuvir

Study Design: A descriptive study

Place and Duration of Study: Memon Medical Institute Hospital, Karachi, from January to September 2016

Methodology: The study population consisted of patients above 18 years, till 80 years of age, of both genders, having chronic infection with HCV. Patients included were treatment-naive, non-responders or relapsers; and among these categories, both cirrhotic and non-cirrhotic patients were included. Initially, genotyping and quantitative PCR test was done, one at the start of treatment then at 4 weeks that is till rapid virological response [RVR] was elicited. Qualitative testing was compared by Chi-square with quantitative assays simultaneously to check sensitivity by qualitative testing

Results: Out of 106 patients, the mean age of the patients was 46.40 +/- 14 years. There were 39 [36.8%] males and 67 [63.2%] females. One hundred [94.3%] were infected with genotype 3. One hundred and five [99.05%] patients responded to sofosbuvir with successful achievement of RVR after 4 weeks. One patient did not achieve RVR [0.94%]. The sensitivity of qualitative test was 99%

Conclusion: Qualitative analysis is a cost-effective and sensitive method in patients treated with sofosbuvir for confirming RVR, especially in developing countries where patients are self-paying with significant financial constraints

Rapid virological and End treatment response of patients treated with Sofosbuvir in Chronic Hepatitis C

Objective: To determine Rapid and End treatment response of patients treated with Sofosbuvir in Chronic Hepatitis C at tertiary care hospital

Methods: It was an observational study conducted at Memon Medical Institute from January 2016 to July 2017. The inclusion criteria for patients was 18 years of age or older, having chronic infection with HCV. Total=201 received sofosbuvir with or without interferon in our OPDs. Patients were categorized into Treatment naive, treatment experienced and decompensated chronic liver disease. Pregnant patients and those not willing to participate were excluded. Initially genotyping and Quantitative HCV RNA test was done

Results: A total of 201 subjects were included in the study with mean age of the patients was 46.22+/- 14.41 years. Of 201 patients, n= 131 [65.2%] chronic hepatitis C, compensated cirrhosis n= 47[23.4%], and with decompensated cirrhosis n=23[11.4%]. Most commonly genotype 3 n= 180 [89.6%] was present followed by genotype 1 n=9 [4.5%], genotype 2 n=1[0.5%], genotype 4 n=1[0.5%]

Of patients with genotype 3, 123 received dual therapy and 57 were given triple therapy. After one month of therapy HCV RNA by PCR, 200[99.5%] achieved RVR, 199[99%] achieved ETR and SVR achieved in 178[88.5%] while remaining 1 patient did not achieved RVR, 2 ETR and 12 patients did not achieved SVR and remaining 11 SVR lost follow up

Conclusion: Sofosbuvir has shown to be very effective and successful with achievement of virological response with little or no resistance in all genotypes mainly genotype 3 treated in our study population. The promising results of our study will aid in better outcomes and therefore help in eradication of the virus