Efficacy of Sofosbuvir Plus Ribavirin with or Without Peginterferon- Alfa in Treatment of a Cohort of Egyptian Patients with Hepatitis C Virus Infection.

Background & Aims: Sofosbuvir is a powerful drug for the treatment of hepatitis C virus (HCV) infection. In comparison to preceding remedies, sofosbuvirbased regimens provide a higher cure rate, fewer side effects, and much lower duration of treatment. The aim of the work was to assess the efficacy and safety of sofosbuvir plus ribavirin with or without peginterferon-alfa in the treatment of a cohort of Egyptian patients with hepatitis C virus infection. METHODS: Two hundred treatment naive patients who were HCV-antibody positive and HCV RNA by PCR positive aged more than 18 years were enrolled in the study and patients were classified into two groups: Group I which included 100 patients who received dual therapy with sofosbuvir plus oral weight based ribavirin for 24 weeks and Group II which included 100 patients on triple therapy with sofosbuvir plus oral weight based ribavirin (as with the dual therapy) and a 180 mcg Peg-INF alpha 2a subcutaneous injection weekly for 12 weeks. The primary end point was a sustained virological response at 12 weeks after end of the treatment determined by quantitative PCR for HCV. RESULTS: Both patients groups had high sustained virological response that was higher in patients receiving triple than dual therapy (94% vs 83%). The adverse events that occurred in the two groups of patients were more evident in a group of patients receiving triple therapy. The side effects were mainly flu like symptoms. CONCLUSIONS: The triple regimen of Pegylated interferon, sofosbuvir plus ribavirin is safe and effective in the treatment of Egyptian patients with hepatitis C virus as well as sofosbuvir and ribavirin alone wit.

Serum TGF-ß, Serum MMP-1, and HOMA-IR as non-invasive predictors of fibrosis in Egyptian patients with NAFLD.

BACKGROUND/AIM: Non-alcoholic fatty liver disease (NAFLD) is an increasingly prevalent cause of chronic liver disease worldwide. A number of these patients progress to nonalcoholic steatohepatitis (NASH) which carries significant morbidity and mortality. The aim of this study is to evaluate the diagnostic value of serum levels of transforming growth factor beta-1 (TGF-ß1) matrix metalloproteinase-1 (MMP-1), and insulin resistance as predictors of fibrosis in Egyptian NAFLD patients. PATIENTS AND METHODS: Fifty patients with NAFLD and different stages of fibrosis were studied. Serum levels of TGF-ß1, MMP-1, and fasting serum insulin were measured; calculation of the homeostasis model assessment for insulin resistance (HOMA-IR) was done. RESULTS: TGF-ß1 gives a sensitivity of 100% and specificity of 94.4% for stage 1 fibrosis, 100% and 93.9%, respectively, for stage 2 fibrosis, and 97.7% and 100%, respectively, for stage 3 fibrosis. MMP-1 showed sensitivity and specificity of 88% and 81.8%, respectively, for stage 2 fibrosis, 90.9% and 55.56%, respectively, for stage 3 fibrosis, but it is of no diagnostic value in stage 1 fibrosis. CONCLUSION: Serum TGF-ß1, MMP-1, and insulin resistance (HOMA-IR) proved to be potentially useful noninvasive markers in predicting fibrosis in NASH patients.