COMPARATIVE ANALYSIS OF ANTIVIRAL THERAPIES IN CHRONIC HCV PATIENTS:  CLINICAL OUTCOMES AND TREATMENT IMPLICATIONS

A ALI; A ULLAH; S KIRBAG

doi:10.64013/bbasr.v2026i1.136

Authors

A ALI Department of Health and Biological Sciences, Abasyn University Peshawar, 2500 Peshawar, Pakistan
A ULLAH Center of Biotechnology and Microbiology, University of Peshawar, Peshawar 25000, Pakistan
S KIRBAG Department of Biology, Faculty of Science, Firat Univerity Firat 23119 Elazig, Turkey

DOI:

https://doi.org/10.64013/bbasr.v2026i1.136

Keywords:

HCV, sustained virological response (SVR), sofosbuvir, ribavirin, daclatasvir, direct-acting antivirals (DAAs)

Abstract

Hepatitis C Virus is an enveloped single-stranded RNA virus of the family Flaviviridae and genus hepacivirus. HCV infection can lead to severe conditions like liver cirrhosis and hepatocellular carcinoma. Different Antiviral drugs are used for the treatment of HCV based on genotypes. This study aimed to assess the clinical efficacy of direct acting antivirals drug used for the treatment of HCV patients. Blood samples of 110 HCV patients were collected and confirmed by ICT, ELISA, and real-time PCR. Furthermore, the patients’ demographic data and biochemical tests were performed before and after the treatment. Patients were classified into two groups: one being treated with sofosbuvir+ribavirin and the other with sofosbuvir+daclatasvir. SVR was determined after 3 and 6 months of treatment. The results showed that male patients (54.5%) were more than females (45.5), and HCV was prevalent in urban areas (62.7%). HCV was found to be highly prevalent in patients aged 36 to 55 (46.4%). The frequent route of transmission was found to be unsafe barber visits (38.2%), followed by unsafe therapeutic injections (31.8%), unsafe dental procedures (24.5%), and blood transfusion (3.6%). Overall, SVR after 24 weeks was 89.1%; for those using sofosbuvir plus ribavirin, SVR was 93.2%, and for sofosbuvir plus daclatasvir, SVR was 84.3%. The adverse effects were noted such as generalize body aches, fatigue, headache, and fever in both DAAs groups. This study concludes that high prevalence of HCV in male patients, mostly from urban areas, with exposure to unsafe barber visits, multiple therapeutic injections, and dental procedures. Sofosbuvir plus ribavirin showed slightly higher efficiency, but overall, the SVR was remarkable for both combinations against chronic HCV infection.

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References

Al Kanaani, Z., Mahmud, S., Kouyoumjian, S. P., & Abu-Raddad, L. J. (2018). The epidemiology of hepatitis C virus in Pakistan: Systematic review and meta-analyses. Royal Society Open Science, 5(4), 180257.

Alter, M. J. (2007). Epidemiology of hepatitis C virus infection. World Journal of Gastroenterology, 13(17), 2436–2448.

Bashir, T., Asim, M., Ahsan, M., Zafar, M. Z., & Hussain, K. (2017). A case report: Patient with the history of hepatitis C virus. Journal of Antivirals & Antiretrovirals, 9(2), 055–057.

Brzdęk, M., Zarębska-Michaluk, D., Invernizzi, F., Cilla, M., Dobrowolska, K., & Flisiak, R. (2023). Decade of optimizing therapy with direct-acting antiviral drugs and the changing profile of patients with chronic hepatitis C. World Journal of Gastroenterology, 29(6), 949–967.

Haider, S. A., Ahmad, B., Ali, S., Haider, A., Bashir, S., & Mahmood, N. (2020). Sofosbuvir and ribavirin combination therapy response in various hepatitis C virus genotypes in Peshawar, Khyber Pakhtunkhwa. Jundishapur Journal of Microbiology, 13(6), e102377.

Hassan, H., Riasat, A., Zia, T., Ishaq, S., & Ullah, A. (2024). classification, prevalence and treatment of Hepacvirius C. Journal of Physical, Biomedical and Biological Sciences, 2025(1), 33.

Haqqi, A., Munir, R., Khalid, M., Khurram, M., Zaid, M., Ali, M., Shah, Z. H., Ahmed, H., & Afzal, M. S. (2019). Prevalence of hepatitis C virus genotypes in Pakistan: Current scenario and review of literature. Viral Immunology, 32(9), 402–413.

Khaliq, A., Ahmad, I., & Afzal, M. S. (2018). HCV treatment with sofosbuvir in Pakistan; current scenario and future perspective. Journal of Bioequivalence & Bioavailability, 10, 1000381.

Khatun, M., & Ray, R. B. (2019). Mechanisms underlying hepatitis C virus-associated hepatic fibrosis. Cells, 8(10), 1249.

Kurniawan, J., Gani, R. A., Hasan, I., Sulaiman, A. S., Lesmana, C. R. A., Jasirwan, C. O. M., Kalista, K. F., Nababan, S. H. H., & Zulkifly, S. (2018). Comparative efficacy of sofosbuvir-ribavirin versus sofosbuvir-daclatasvir for treatment of chronic hepatitis C in an area with limited NS5A inhibitor availability. Indian Journal of Gastroenterology, 37(6), 520–525.

Mahmood, H., & Raja, R. (2017). Risk factors of hepatitis C in Pakistan. Gastroenterology & Hepatology: Open Access, 7(6), 00259.

Mooneyhan, E., Qureshi, H., Mahmood, H., Tariq, M., Maqbool, N. A., Anwar, M., Aslam, M., Azam, F., Blach, S., Khan, A. G., & Hamid, S. (2023). Hepatitis C prevalence and elimination planning in Pakistan, a bottom-up approach accounting for provincial variation. Journal of Viral Hepatitis, 30(4), 345–354.

Moradpour, D., & Penin, F. (2013). Hepatitis C virus proteins: From structure to function. In Hepatitis C Virus: From Molecular Virology to Antiviral Therapy (pp. 113–142).

Néant, N., & Solas, C. (2020). Drug-drug interactions potential of direct-acting antivirals for the treatment of chronic hepatitis C virus infection. International Journal of Antimicrobial Agents, 56(1), 105571.

Pandian, C. J., Murugan, N. A., Rajendren, S. M., & Jeyaraman, J. (2023). Computer-aided vaccine design for selected positive-sense single stranded RNA viruses. Indian Journal of Biochemistry and Biophysics, 60(4), 281–296.

Petruzziello, A., Loquercio, G., Sabatino, R., Balaban, D. V., Ullah Khan, N., Piccirillo, M., Rodrigo, L., di Capua, L., Guzzo, A., Labonia, F., & Botti, G. (2019). Prevalence of Hepatitis C virus genotypes in nine selected European countries: A systematic review. Journal of Clinical Laboratory Analysis, 33(5), e22876.

Petruzziello, A., Marigliano, S., Loquercio, G., Coppola, N., Piccirillo, M., Leongito, M., Azzaro, R., Izzo, F., & Botti, G. (2017). Hepatitis C Virus (HCV) genotypes distribution among hepatocellular carcinoma patients in Southern Italy: A three year retrospective study. Infectious Agents and Cancer, 12, 1–8.

Saleha, S., Kamal, A., Ullah, F., Khan, N., Mahmood, A., & Khan, S. (2014). Prevalence of hepatitis C virus genotypes in district Bannu, Khyber Pakhtunkhwa, Pakistan. Hepatitis Research and Treatment, 2014, 165826.

Sandmann, L., Schulte, B., Manns, M. P., & Maasoumy, B. (2019). Treatment of chronic hepatitis C: Efficacy, side effects and complications. Visceral Medicine, 35(3), 161–170.

Sarwar, S., & Khan, A. A. (2017). Sofosbuvir based therapy in Hepatitis C patients with and without cirrhosis: Is there difference?. Pakistan Journal of Medical Sciences, 33(1), 37–41.

Thursz, M., & Fontanet, A. (2014). HCV transmission in industrialized countries and resource-constrained areas. Nature Reviews Gastroenterology & Hepatology, 11(1), 28–35.

Ullah, A., Maryam, A., Malik, G., Hameed, H., Hussain, K., Ahmad, J., Haq, I., Haq, M., Aljowaie, R. M., Abougazia, E. M., & Chen, T. W. (2023). Sustained virological response to antiviral drugs in treatment of different genotypes of HCV cirrhotic patients. Pakistan Journal of Pharmaceutical Sciences, 36(3), 1009–1015.

Ullah, A., Rehman, I. U., Ahmad, J., Gohar, M., Ahmad, S., & Ahmad, B. (2020). Hepatitis-C virus and cirrhosis: An overview from Khyber Pakhtunkhwa province of Pakistan. Viral Immunology, 33(5), 396–403.

Ullah, A., Rehman, I. U., Ahmad, J., Odenthal, M., Ahmad, S., Nadeem, T., & Ahmad, B. (2021). Phylogenetic analysis of the 5ʹ untranslated region of HCV from cirrhotic patients in Khyber Pakhtunkhwa, Pakistan. Scientific Reports, 11(1), 15023.

Umer, M., & Iqbal, M. (2016). Hepatitis C virus prevalence and genotype distribution in Pakistan: Comprehensive review of recent data. World Journal of Gastroenterology, 22(4), 1684–1700.

Zeba, M. T. A., Sanou, M., Bisseye, C., Kiba, A., Nagalo, B. M., Djigma, F. W., & Sagna, T. (2014). Characterisation of hepatitis C virus genotype among blood donors at the regional blood transfusion centre of Ouagadougou, Burkina Faso. Blood Transfusion, 12(Suppl 1), s151–s157.