Hepatitis C in Egypt &amp;ndash; past, present, and future

Elgharably, Ahmed; Gomaa, Asmaa; Crossey, Mary Margaret Elizabeth; Norsworthy, Peter; Waked, Imam; Taylor-Robinson, Simon D

doi:10.2147/ijgm.s119301

Cited by 163 publications

(145 citation statements)

References 26 publications

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“…It is also worth mentioning that all our patient who discontinued treatment due to HCC were on SOF + DAC combination of two standalone drugs ± RBV, an observation that may be of significance in future as regards the debatable link between DAAs and HCC. Indeed, our findings are not different from the data of some previous studies, which also discussed the safety and tolerability of these drugs …”

Section: Discussioncontrasting

confidence: 69%

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Tolerability and effectiveness of generic direct‐acting antiviral drugs in eradication of hepatitis C genotype 4 among Egyptian patients

Lashen

Madkour

Aboufarrag

2019

Liver International

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Background We investigated tolerability and effectiveness of generic, less expensive direct antiviral drugs in the treatment of hepatitis C virus genotype 4 (HCV GT‐4) in an Egyptian cohort. Patients and Methods Retrospectively, we analysed data from 648 patients with HCV GT4 attending Alexandria Main University Hospital from January 2016 to May 2017 [488 treatment naïve/160 treatment‐experienced/288 with chronic hepatitis/360 with cirrhosis]. Patients received generic sofosbuvir/ledipasvir (n = 168, treatment naïve = 136, treatment‐experienced = 32) or sofosbuvir/daclatasvir (n = 480, treatment naïve = 352, treatment‐experienced = 128) ± ribavirin. We assessed sustained virologic response 12 weeks after treatment, non‐response, relapse, treatment discontinuation and drug adverse reactions. Results An overall sustained virologic response 12 weeks after treatment was achieved in 97.8%, non‐response in 0.6%, relapse in 0.3% and discontinuation of treatment in 1.3% of patients. Sofosbuvir/ledipasvir ± ribavirin regimen attained an overall sustained virologic response 12 weeks after treatment in 96.4% of patients (100% of treatment‐experienced vs 95.6% of treatment naïve, P = 0.28), vs 98.3% for sofosbuvir/daclatasvir ± ribavirin regimen (100% of treatment‐experienced vs 97.7% of treatment naïve, P = 0.08). No severe drug adverse events or deaths were reported except anaemia due to ribavirin. Conclusion Generic direct antiviral drugs used in treating Egyptian patients with HCV GT‐4 demonstrated equal potency, safety and tolerability compared to original brands, with low cost which would help to provide treatment to a larger scale of patients.

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Section: Discussioncontrasting

confidence: 69%

“…The safety of DAAs has been already assessed in some clinical trials, revealing that they are well tolerated with almost no discontinuation rate or life‐threatening adverse events. However, future follow‐up studies are still necessary due to short‐term experience with these drugs …”

Section: Introductionmentioning

confidence: 99%

Tolerability and effectiveness of generic direct‐acting antiviral drugs in eradication of hepatitis C genotype 4 among Egyptian patients

Lashen

Madkour

Aboufarrag

2019

Liver International

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“…Amongst the most common chronic diseases in Egypt is hepatitis C viral infections, which, accounts for 11.5 million patients . Very recently, a new generation of antivirals have been released such as daclatasvir dihydrochloride (DAC) which acts by inhibition of non‐structural protein 5A (NS5A) .…”

Section: Introductionmentioning

confidence: 99%

Pencil Graphite Electrode Decorated with Xylenol Orange Flakes for Studying Possible Pharmacokinetic Interaction Between Vardenafil and Daclatasvir

et al. 2019

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The main aim of the current work is to investigate possible pharmacokinetic interactions between vardenafil hydrochloride (VAR), which is used for the treatment of erectile dysfunction and daclatasvir dihydrochloride (DAC), which is used for the treatment of chronic hepatitis C viral infection when they are concomitantly administered. Therefore, a sensitive and selective square‐wave voltammetric method was developed and validated for simultaneous determination of VAR and DAC using disposable pencil graphite electrode (PGE) modified with xylenol orange (X.O.) flakes as an electrochemical sensor. A full investigation of the experimental parameters for obtaining the highest electroanalytical signal with sufficient resolution between the oxidation peaks of two compounds was performed. It was found that VAR and DAC were resolved on X.O./PGE with different potentials at 1.4 V and 0.9 V, respectively using Britton‐Robinson buffer (pH 2.2) and 0.1 mol L−1 KCl as a supporting electrolyte. In addition, with the aid of cyclic voltammetry, a mechanistic scheme for the oxidation behaviour of both VAR and DAC was suggested. The proposed square wave voltammetric method was successfully applied for trace quantification of VAR and DAC in male rabbits. The suggested approach shows detection and quantification limits in rabbit plasma samples of 0.06 and 0.17 μmol L−1, respectively for VAR and 0.13 and 0.39 μmol L−1, respectively for DAC. The pharmacokinetic parameters of VAR alone and in combination with DAC after oral administration to rabbits were successfully estimated. The obtained results confirm that when DAC is co‐administered with VAR, plasma concentration of VAR increases, which necessitates dose adjustment for VAR to prevent toxicological consequences in patients.

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“…In developing countries, acute hepatitis C infections are mainly due to unsafe health care procedures; Egyptian mass antischistosomal treatment using inadequately sterilized syringes in the 1960s and 1970s is distinctive in this regard, while injection drug use takes the second position [7]. In Egypt, definite deterministic data concerning prevalence or incidence of AHC are lacking.…”

Section: Introductionmentioning

confidence: 99%

Acute Hepatitis C Virus Infection and Directly Acting Anti-Hepatitis C Virus Drugs

Alhaddad¹,

Elsabaawy²,

Elshaarawy³

et al. 2017

J Gastrointest Dig Syst

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The best of care of Acute hepatitis C (AHC) infections in the evolving era of all oral directly acting antiviral drugs (DDAs) needs revision. The inevitable chronic liver disease in 80% of AHC infections justifies the advent of DDAs that expectedly will guarantee high cure rates. Unlike interferons, the short and ultra-short all oral DDAs regimens had revolutionized treatment strategies with better adherence and fewer complications. However, the costly price of DAAs added to the average expertise is still contrarily active. Up-to-date, studies concerning DAAs treatment for AHC mono-infection are sparse; indeed this represents an unmet need in modern AHC management.

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Hepatitis C in Egypt – past, present, and future

Cited by 163 publications

References 26 publications

Tolerability and effectiveness of generic direct‐acting antiviral drugs in eradication of hepatitis C genotype 4 among Egyptian patients

Tolerability and effectiveness of generic direct‐acting antiviral drugs in eradication of hepatitis C genotype 4 among Egyptian patients

Pencil Graphite Electrode Decorated with Xylenol Orange Flakes for Studying Possible Pharmacokinetic Interaction Between Vardenafil and Daclatasvir

Acute Hepatitis C Virus Infection and Directly Acting Anti-Hepatitis C Virus Drugs

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