TITLE:
Chronic Viral Hepatitis C: Before and after Direct Acting Antivirals (DAA) in Morocco
AUTHORS:
Hakima Abid, Maryam Khayari, Hajar Cherkaoui, Maria Lahlali, Nada Lahmidani, Mounia Elyousfi, Nourdin Aqodad, Sidi Adil Ibrahimi, Mohamed El Abkari
KEYWORDS:
Viral Hepatitis C, Pegylated Dual Therapy, Direct Acting Antivirals, Tolerance
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.12 No.3,
March
15,
2022
ABSTRACT: For a long time, a combination of interferon and ribavirin has been used
to treat viral hepatitis C, but the
sustained virological response was only achieved in 45% of cases and
side effects were serious[1]. Direct acting antivirals (DAA) have provided a cure for almost everyone
with hepatitis C, with few side effects. The Purpose of Our Work is to
compare the results of treatment for viral hepatitis C before and after DAA. Patients
and Methods: This
is a retrospective study, bringing together all patients with chronic viral
hepatitis C treated between January 2009 and March 2020 at the University
Hospital Hassan II in Fez, Morocco. The epidemiological, clinical, biological,
virological characteristics of the included patients were collected from the
two groups: A, treated with interferon and ribavirin or by triple therapy and
B, treated with DAA. Results: 162 patients were included, the average age was 55 y/o, with 90 women
and 72 men. 88 patients (54.3%) were already cirrhotic, of which 61 were
compensated and 27 were decompensated. Genotype 1 was dominant with a frequency
of 71.6%, 107 patients (66%) initially treated with old HCV treatments and 55
(34%) treated with DAA. Sustained viral response was obtained in 59 cases
(55.14%) in group A versus 54 cases (98.18%) in group B with a very significant
difference (p i.e. 2% in group B (p = 0.019). 14 patients relapsed in group A (13.1%) versus 0
patient in group B (p = 0.003). The tolerance of the treatment was excellent in
group B as a whole with only five patients (9%) reported side effects which
were minor, not leading to the discontinuation of treatment while the side
effects were major in 49 patients (45.7%) in group A with led to the permanent
discontinuation of treatment in 6 patients. The difference in side effects
between the two groups was very significant with (p Conclusion:
Our study has shown the superiority of DAA in terms of efficacy and tolerance
compared to the old treatments for chronic hepatitis C. In addition, these
treatments allow almost systematic viral elimination and therefore consequently
a reduction in the risk of complications hepatic with a short time of treatment.