Biography
Biography: Hasan Ahmed El-Garem
Abstract
Egypt has the highest prevalence of hepatitis C virus infection in the world. The prevalence of HCV viremia was estimated to be 7.3%, and 90% of them have genotype 4. Until 2007, hepatitis C virus treatment was not offered by the government. In 2007, an Egyptian National Committee for Control of Viral Hepatitis (NCCVH) has been established. Number of patients treated with PEG-INF and ribavirin was 350,000. A further step in treating HCV was FDA approval of Sofosbuvir in 2013. Egyptian government made an agreement with the manufacturer company Gilead to decrease the cost of the course for 3 months from 84000$ to 900$. New treatment protocol started in September 2014. The protocol categorized patients into 2 groups: Group 1 - Patients who were eligible to receive interferon were treated with daily Sofosbuvir (400 mg) and weight-based ribavirin plus weekly peginterferon for 12 weeks and Group 2 - Patients who were not eligible to receive interferon were treated by daily sofosbuvir (400 mg) plus weight-based ribavirin for 24 weeks. A further step in treating HCV was achieved after availability of the new drugs, daclatasvir and ritonavir boosted paritaprevir/ombitasvir in Egypt. Treatment protocol was updated in November 2015. Patients were categorized into 4 groups: 1 - Easy to treat group, was treated by the following regimen for 12 weeks; sofosbuvir (400 mg) plus daclatasvir (60 mg). 2 - Difficult to treat group, was treated by the following regimen for 12 weeks; sofosbuvir (400 mg) plus daclatasvir (60 mg) plus ribavirin (600 mg up to 1000 mg). 3 - Third regimen was for patients with post organ transplantation and patients who failed previous sofosbuvir containing regimen. These patients were treated by the following regimen for 24 weeks; sofosbuvir (400 mg) plus daclatasvir (60 mg) plus ribavirin (600 mg up to 1000 mg). 4 - Fourth regimen for patients with glomerular filtration rate less than 30 ml/min were treated by ritonavir boosted paritaprevir/ombitasvir plus ribavirin for 12 weeks. Results of treatment will be mentioned in the presentation.