Pretreatment serum alpha fetoprotein and its relation to sustained virologic response in patients with chronic HCV infection treated with direct-acting antiviral therapy

Abstract

Background and study aim. The introductionof directacting antiviral agents (DAAs) hasincreased sustained virologic response (SVR) rates inpatients with chronic hepatitis C infection (CHC). Theaim of this study is to evaluate the efficacy of DAAsin treatment of Egyptian patients with CHC, and todetermine the parameters associated with non-responseto DAAs Patients and methods. This study included200 treatment-naïve chronic hepatitis C patients whowere divided into two groups and treated accordingto the Egyptian National Treatment Program forHepatitis C Virus. Group 1 consisted of 100 easy-totreatpatients who were administered sofosbuvir 400mg daily/daclatasvir 60 mg daily for 3 months, whilegroup 2 included 100 difficult-to-treat patients treatedby Sofosbuvir 400 mg/ daclatasvir 60 mg /ribavirindaily for 3 months Results. The overall patient sustainedvirologic response (SVR) in the present studywas 93.5% (187/200). SVR in group 1 was 100%, whilegroup 2 showed SVR of 87% (87/100). Comparisonbetween patients with and without SVR revealed nostatistically significant differences regarding age andsex distribution, serum albumin, bilirubin, transaminaseslevel, INR and platelets count. However,patients who were non-responders had signi-ficantlyhigher pre-treatment alpha fetoprotein (AFP) levelsthan responders Conclusions. Treatment of CHCpati-ents with DAAs is associated with highersustained virologic response, particularly in easy-totreatpatients. AFP level may aid in prediction ofnon-responders to DAAs