Hepatitis C virus infection: Epidemiology in Egypt, Pathophysiology and DAAs-based therapy

Abstract

Hepatitis C virus (HCV) was first identified in 1989. The situation in Egypt is dire. The prevalence of HCV genotype 4 (GT-4) is 14.7 percent. About 10% of the middle-aged population (ages 15 to 59) is infected with HCV. As a result, the Hepatitis C virus is considered extremely contagious. The introduction of the directly acting antiviral medications (DAAs), sofosbuvir or simeprevir, in GT-4 patients with PEGylated interferon (PEG-IFN) and ribavirin (RBV) in a 12-week regimen substantially increased sustained virological response (SVR) rates for HCV GT-4 in 2014. Daclatasvir (DCV) is the first DAA identified in the family of HCV NS5A inhibitors with antiviral activity against a variety of HCV genotypes. It is well-tolerated and safe, with a low risk of drug-drug interactions and resistance. Many investigations have discovered a rapid initial viral decline followed by a gradual decline in viral RNA, demonstrating DCV's inhibitory effect on viral reproduction, assembly, and secretion. DCV is a CYP3A4 substrate as well as a substrate for P-glycoprotein (P-GP), the most common drug efflux transporter, which are both expressed in hepatocytes and enterocytes, however, it is not a BCRP substrate (Breast Cancer Resistance Protein). Concomitant treatment of DCV with other medications targeting CYP3A4 or P glycoprotein may change its pharmacokinetic characteristics.

Hydrazineylidene‐3‐oxopropanal derivatives as antiviral agents for treatment of HBV and HCV: Experimental, DFT, and molecular docking studies

“…[7][8][9] Hepatitis B virus DNA is double-stranded and belongs to the Hepadna-viridae family. [10,11] However, Interferon (IFN-a, including non-pegylated and pegylated) and nucleoside analogues are now FDA-approved HBV inhibitors for antiretroviral therapy (lamivudine, adefovir, tenofovir, telbivudine, and entecavir). [12] Both therapy methods have been shown in numerous clinical trials to lower HBV DNA concentration in liver cells, block HBV replication, and slow the progression of liver disease.…”

Direct Acting Antiviral Drugs: Pharmacokinetics and Drug-Drug Interactions

“…Egypt has the highest global HCV prevalence (14.7%), and type 4 is the most common genotype there, with genotype 1 coming in second with 26% of the cases [1]. Hepatocellular carcinoma, liver cirrhosis, and liver failure can all be caused by the chronic infection of HCV, which is also linked to a significant risk of morbidity and mortality [2]. By diagnosing HCV early and receiving effective therapeutic care, these complications can be prevented [2].…”

“…Hepatocellular carcinoma, liver cirrhosis, and liver failure can all be caused by the chronic infection of HCV, which is also linked to a significant risk of morbidity and mortality [2]. By diagnosing HCV early and receiving effective therapeutic care, these complications can be prevented [2]. The endpoint of treatment: sustained virological response (SVR), known as having no detectable serum HCV RNA twenty-four weeks following the start of treatment, is the focus of therapy [3].…”