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Efficacy and safety of sofosbuvir plus simeprevir therapy in Egyptian patients with chronic hepatitis C: a real-world experience
  1. Hisham R El-Khayat1,
  2. Yasser M Fouad2,
  3. Mohsen Maher3,
  4. Hussain El –Amin4,
  5. Hala Muhammed5
  1. 1Gastroenterology and Endemic Medicine Department, Theodore Research Institute, Cairo, Egypt
  2. 2Gastroenterology and Endemic Medicine Department, Minia University, Minia, Egypt
  3. 3Gastroenterology and Endemic Medicine Department, Ain Shams University, Cairo, Egypt
  4. 4Internal Medicine Department, Assuit University, Assuit, Egypt
  5. 5Gastroenterology and Endemic Medicine, Endemic Medicine Department, Minia University, Faculty of Medicine, Minia, Egypt
  1. Correspondence to Dr Yasser Mahrous Fouad, Gastroenterology and Endemic Medicine, Endemic Medicine Department, Faculty of Medicine, Minia University, Minia 19111, Egypt; yasserfouad10{at}


Background Simeprevir plus sofosbuvir (SIM/SOF) regimen was recommended by professional guidelines for certain patients with HCV genotype 1 infection and there is lack of data about this regimen in patients with genotype 4 infection.

Aim To evaluate the efficacy and safety of this regimen in Egyptian patients with chronic HCV genotype 4 infection in the real world.

Methods Multicentre observational study included 583 patients with HCV genotype 4 infection who began 12 weeks of treatment with SIM plus SOF. Demographic, clinical and virological data as well as adverse outcomes were collected. Treatment naïve patients were 342 (59%) of all included patients, 45% of patients had severe fibrosis (F3 and F4) while 55% had mild fibrosis (F1 and F2) and the primary outcome was sustained virological response (SVR).

Results The overall SVR rate was 95.7% (558 out of 583 patients). In total, SVR12 in naïve patients with mild fibrosis score (F1 and F2) was achieved in 98.9% (94/95) for F1 and 98.1% (105/107) for F2, while naïve patients with severe fibrosis (F3 and F4) achieved SVR of 97.7% (86/88) for F3 and (42/52) 80.8% for F4. SVR in patients with previous interferon treatment achieved in 100% (45/45) for patients with F1 and 98.7% (74/75) for F2. While 94.7% (72/76) in experienced patients with F3; and 88.9% (40/45) for F4 achieved SVR12. Notable side effects included rash in 21 patients, photosensitivity in 18 patients, pruritus in 44 patients and hyperbilirubinemia in 42 patients.

Conclusions A 12-week regimen of simeprevir/sofosbuvir was efficacious and well tolerated by treatment-naïve and treatment-experienced patients with chronic HCV genotype 4.

  • HCV

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