Hepatology International

, Volume 12, Issue 4, pp 348–355 | Cite as

Efficacy and safety of sofosbuvir plus daclatasvir with or without ribavirin: large real-life results of patients with chronic hepatitis C genotype 4

  • Adel Abdel-MoneimEmail author
  • Alaa Aboud
  • Mohamed Abdel-Gabaar
  • Mohamed I. Zanaty
  • Mohamed Ramadan
Original Article


Background and aim

Clinical studies evaluating the efficacy of daclatasvir (DCV) for treatment of chronic hepatitis C virus (HCV) genotype 4 (GT4) infection are scarce. This study aims to evaluate the efficacy and safety of DCV plus sofosbuvir (SOF) with or without ribavirin (RBV) for treatment of Egyptian patients infected with HCV GT4.


Between April 2016 and March of 2017, a large cohort of 946 patients with chronic HCV GT4 was enrolled for completing the treatment. Patients were classified into two groups: group 1 (easy to treat) was treated with a dual therapy of SOF/DCV daily for 12 weeks and group 2 (difficult to treat) was treated with a triple therapy of SOF/DCV/RBV daily for 12 weeks. Efficacy and safety of the treatments were estimated, and baseline characters associated with sustained virological response at 12 weeks post-treatment (SVR12) were investigated.


Among the patient’s cohort, SVR12 was achieved by 94% (891/946) in the overall patients, by 95% (718/758) in the easy-to-treat group, and by 92% (173/188) in the difficult-to-treat group. The most common adverse events recorded were fatigue, headache, nausea, asthenia, and gastrointestinal troubles. No patient discontinued treatment due to severe adverse events.


The findings from the present study suggested that SOF/DCV (with or without RBV) regimen exhibited high effectiveness, was well tolerated in the treatment of chronic HCV GT 4, and revealed itself as a better option for patients with advanced liver disease, making the eradication of HCV a more realistic target to achieve.


Egyptian patients Direct antiviral agents Easy-to-treat patients Difficult-to-treat patients 



The authors are thankful to the staff members of the National Treatment Centers in Beni Suef for providing the facilities used in this study.

Compliance with Ethical Standards

Ethical approval

The study was approved by each center’s institutional review board. In addition, written consent was obtained from all the patients, and the ethical committee approved the study protocol which conformed to the Egyptian National guidelines and was performed in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines (decision date: 17.2.2016).

Supplementary material

12072_2018_9868_MOESM1_ESM.doc (92 kb)
Supplementary material 1 (DOC 91 kb)


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Copyright information

© Asian Pacific Association for the Study of the Liver 2018

Authors and Affiliations

  1. 1.Molecular Physiology Division, Faculty of ScienceBeni-Suef UniversityBeni SuefEgypt
  2. 2.Tropical Medicine Department, Faculty of MedicineBeni-Suef UniversityBeni SuefEgypt
  3. 3.Biochemistry Division, Faculty of ScienceBeni-Suef UniversityBeni SuefEgypt
  4. 4.Biotechnology Department, Faculty of Postgraduate Studies for Advanced ScienceBeni-Suef UniversityBeni SuefEgypt

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