The effectiveness and safety of direct-acting antivirals for hepatitis C virus treatment: A single-center experience in Saudi Arabia

Background: The introduction of direct-acting antivirals (DAA) to treat the hepatitis C virus (HCV) over-came many drawbacks of interferon-based therapy. DAA achieved sustained viral response (SVR) rates above 90% and overcame many drawbacks of pegylated interferon regimens.The HCV genotype (GT) dis-tribution varies by geographical area, with GT-4 being most prevalent in the Middle East region, including Saudi Arabia. Yet, the real-world evidence about using DAAs in the Saudi population is limited.Thus, the aim of this study to investigate the effectiveness and safety of DAAs in Saudi patients with HCV infection.Methods: A retrospective cohort study included patients treated with DAAs from 2015 to 2017 at a ter-tiary care hospital in Riyadh, Saudi Arabia. All patients with HCV treated with either ledipasvir plus sofos-buvir (LDS/SOF) +/- ribavarin (RBV) or ombitasvir-paritaprevir-ritonavir (OBV/PTV/r) +/- dasabuvir (DSV) +/- RBV were included. Using a per-protocol analysis, the effectiveness outcome was the end-of -treatment response (EOTr) and Sustained virologic reponce12 weeks after competing the regimen (SVR12). The secondary safety outcome was the adverse event related to the therapy reported by the patients.Results: A total of 97 patients were included; with the majority infected with GT-4 (64 %), followed by GT-1 (18 %), in addition to 8 % having a mixed GT (1 + 4). The EOTr and SVR12 rates were 98 % and 96 %, respectively. SVR12 was 94.4 % within the LDS/SOF +/- RBV group and 97.7 % within the OBV/PTV/ r +/- DSV +/- RBV group. Only 4 % had a response failure due to relapse or breakthrough, and all were infected with mixed GT1 + 4. Medications were well tolerated with minimal side effects, including vomiting, nau-sea, and weakness. Conclusion: DAAs regimens are associated with high rates of SVR12 and are well tolerated with a good safety profile in Saudi HCV-infected patients.(c) 2022 The Authors. Published by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).