Assessment of Hepatic Steatosis Before and After Treatment In Egyptian HCV Patients Treated With DAAs Using Non Invasive Parameters

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tareq M Yosef ◽  
Wesam A Ibrahim ◽  
Sarah A El-Nakeep ◽  
Ahmed M ElGhandour ◽  
Mariam W Gerges
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatic Steatosis ◽  
Military Hospital ◽  
Hcv Rna ◽  
Major Health Problem ◽  
Statistical Significant Difference ◽  
Significant Difference ◽  
Apri Score ◽  
The Mean

Abstract Background Hepatitis C virus (HCV) is a major health problem worldwide. More than one million people die each year from hepatitis C virus (HCV) related diseases. Aim of the Work to evaluate the effect of direct acting antiviral drugs on hepatic steatosis in naïve HCV chronically infected Egyptian patients after reaching SVR12. Patients and Methods study was carried out on 100 treatment naive patients with chronic infection of HCV attending the out-patient clinic. The patients were diagnosed having HCV by detecting HCV antibodies by ELISA & PCR for HCV RNA at The Gastro-enterolgy and Hepatology Department, Ain Shams University and Kobry El Koba Military Hospital between August 2017 till February 2019. Results The mean TG, mean s. cholesterol and APRI Score decreased significantly showing a high statistical significant difference between baseline and SVR12. The mean HDL and LDL significantly increased showing a high statistical significant difference between baseline and SVR12. NAFLD Score increased from baseline to SVR12 showing a statistical significant difference in NAFLD Score between baseline and SVR12. Fibroscan median mean decreased showing a highly statistical difference in Fibroscan Median between baseline and SVR12. Out of 100 patients, cirrhosis regressed to F3 in 33 patients, F2 in 3 patients and didn’t regress to F1 in any patient, while the majority (43 patients) remained as F4 at SVR12. Conclusion APRI Score mean and Fibroscan median mean were significantly decreased, while NAFLD Score was increased among the studied groups from baseline and SVR12.

scholarly journals Microelimination of hepatitis C in patients with chronic hemolytic anemias: a single-center experience

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Walaa M. Hashem ◽  
Manal Hamdy El-Sayed ◽  
Ossama A. Ahmed ◽  
Hany M. Dabbous ◽  
Mohamed Kamal Shaker ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Adverse Events ◽  
Hcv Rna ◽  
Special Population ◽  
Hepatic Decompensation ◽  
Delivery Of Care ◽  
Need For Treatment ◽  
Single Center Experience ◽  
Significant Difference

Abstract Background Patients with chronic hemolytic anemias (CHA) are at a high risk for transfusion-transmitted infections. Various studies in Egypt have shown a prevalence of hepatitis C virus (HCV) infection in 24–37% of those patients. Elimination of hepatitis C virus (HCV) in patients with CHA would prevent early progression of liver disease. In this study, we aimed to assess the efficacy, safety, and tolerability of sofosbuvir (SOF) and daclatasvir (DAC) in the special population of HCV-infected patients with CHA. In this prospective study, 21 consenting hepatitis C patients were recruited and treated using ribavirin-free SOF/DAC regimen for either 12 or 24 weeks according to categorization of patients into easy or hard-to-treat in accordance with the national protocols. Sustained virological response was assessed by RT-PCR for HCV-RNA at 12 weeks post-treatment (SVR12). Any treatment-related adverse events were noted. Results All patients were adherent to treatment with no discontinuation of therapy. SVR12 was achieved in 19 out of 21 patients (90.5%). There was a significant improvement in levels of ALT (p<0.009) after completion of therapy. On the other hand, the hemoglobin, total bilirubin, and ferritin levels showed a non-significant difference (p<0.501, p<0.542, and p<0.339, respectively). Moderate adverse events were observed in 2 out of 21 patients (9.5%), including sickling crisis and hepatic decompensation. Conclusion The results of this study substantiate the favorable efficacy, safety, and tolerability of ribavirin-free direct-acting antivirals (DAAs) in the special population of HCV-infected patients with CHA. Micro-elimination of HCV in special patient populations allows for pragmatic delivery of care to patients with co-morbid conditions who are in most need for treatment and allows for achievement of global elimination of HCV worldwide.

scholarly journals Prevalence of Hepatitis C Virus in the Population of Albania for the Period 2007-2010

2014 ◽  
Vol 2 (3) ◽  
pp. 525-528 ◽  
Author(s):  
Hysaj Vila Brunilda ◽  
Shundi Lila ◽  
Abazaj Erjona ◽  
Bino Silva ◽  
Rexha Tefta
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Age Groups ◽  
Viral Disease ◽  
Hcv Infection ◽  
University Hospital ◽  
P Value ◽  
Hcv Rna ◽  
Significant Difference ◽  
Males And Females

BACKGROUND: Hepatitis C is a blood-borne, infectious, viral disease that is caused by a hepatotropic virus called Hepatitis C virus (HCV).AIM: The aim of this study is to determine the prevalence of active HCV infection (HCV–RNA) in the cases that were anti-HCV positive.MATERIAL AND METHODS: Plasma of 301 high-risk for HCV infection consecutive from University Hospital Centre “Mother Theresa” Tirana-Albania, during January 2007 to December 2010 was included in this study. To identify the presence of HCV RNA, the samples were examined by Cobas Amplicor HCV test (qualitative method).RESULTS: From 301 samples analyzed in total, 214 of them resulted positive for the presence of HCV-RNA's, corresponding to a prevalence of 71.1%, with 95% CI interval [65.8 - 75.9] for value of χ2 = 52.7 p value <0.0001. Divide by the sex 56% were males and 44% females, with statistically significant difference between them for value χ2 =4306 p value=0.0380. Among the age groups the highest prevalence was observed in the age groups > 25 years with a significant difference with other age groups for p value <0.001.CONCLUSION: Among tested samples, 71.1 % were confirmed to be positive for HCV –RNA infections. The prevalence of male was highest compared to female. For males and females infected the prevalence was highest in the age group of > 25 years.

scholarly journals Using Pharmacokinetic and Viral Kinetic Modeling To Estimate the Antiviral Effectiveness of Telaprevir, Boceprevir, and Pegylated Interferon during Triple Therapy in Treatment-Experienced Hepatitis C Virus-Infected Cirrhotic Patients

2014 ◽  
Vol 58 (9) ◽  
pp. 5332-5341 ◽  
Author(s):  
Cédric Laouénan ◽  
Patrick Marcellin ◽  
Martine Lapalus ◽  
Feryel Khelifa-Mouri ◽  
Nathalie Boyer ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Triple Therapy ◽  
Pegylated Interferon ◽  
Hcv Rna ◽  
Second Phase ◽  
Compensated Cirrhosis ◽  
Viral Kinetic ◽  
Significant Difference ◽  
Infected Cells

ABSTRACTTriple therapy combining a protease inhibitor (PI) (telaprevir or boceprevir), pegylated interferon (PEG-IFN), and ribavirin (RBV) has dramatically increased the chance of eradicating hepatitis C virus (HCV). However, the efficacy of this treatment remains suboptimal in cirrhotic treatment-experienced patients. Here, we aimed to better understand the origin of this impaired response by estimating the antiviral effectiveness of each drug. Fifteen HCV genotype 1-infected patients with compensated cirrhosis, who were nonresponders to prior PEG-IFN/RBV therapy, were enrolled in a nonrandomized study. HCV RNA and concentrations of PIs, PEG-IFN, and RBV were frequently assessed in the first 12 weeks of treatment and were analyzed using a pharmacokinetic/viral kinetic model. The two PIs achieved similar levels of molar concentrations (P= 0.5), but there was a significant difference in the 50% effective concentrations (EC50) (P= 0.008), leading to greater effectiveness for telaprevir than for boceprevir in blocking viral production (99.8% versus 99.0%, respectively,P= 0.002). In all patients, the antiviral effectiveness of PEG-IFN was modest (43.4%), and there was no significant contribution of RBV exposure to the total antiviral effectiveness. The second phase of viral decline, which is attributed to the loss rate of infected cells, was slow (0.19 day−1) and was higher in patients who subsequently eradicated HCV (P= 0.03). The two PIs achieved high levels of antiviral effectiveness. However, the suboptimal antiviral effectiveness of PEG-IFN/RBV and the low loss of infected cells suggest that a longer treatment duration might be needed in cirrhotic treatment-experienced patients and that a future IFN-free regimen may be particularly beneficial in these patients.

Vertical Hepatitis C Virus Transmission is not Related to Mother-Child Class-1 HLA Concordance

2007 ◽  
Vol 20 (4) ◽  
pp. 827-831 ◽  
Author(s):  
C. Azzari ◽  
G. Indolfi ◽  
L. Betti ◽  
M. Moriondo ◽  
C. Massai ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Vertical Transmission ◽  
Virus Transmission ◽  
Human Leukocyte ◽  
Hcv Rna ◽  
Significant Difference ◽  
Class 1 ◽  
Child Class ◽  
Hla Class 1

Mother-child human leukocyte antigen (HLA) diversity is protective for vertical transmission of some viruses. The aim of this study is to evaluate the role of mother-child HLA diversity on hepatitis C virus (HCV) vertical transmission. Forty consecutive HCV infected and 46 consecutive control uninfected children born to HCV-RNA positive mothers were evaluated for HLA class-1 type concordance with their mothers. No significant difference in the degree of HLA concordance was found between HCV infected and uninfected children both when A, B, C ( p=0.30) and when only A and B alleles were evaluated ( p=0.59). Mother-infant HLA concordance does not affect HCV vertical transmission.

scholarly journals Correlations Between METAVIR Staging, the Viral Load and Alanine Aminotransferase Levels in Patients with Chronic Hepatitis C, Before and after 12 Weeks of Antiviral Treatment

2019 ◽  
Vol 70 (7) ◽  
pp. 2420-2424
Author(s):  
Nicoleta Craciun Ciorba ◽  
Ilie Marius Ciorba ◽  
Ion Claudiu Puiac ◽  
Ligia Ariana Bancu
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Alanine Aminotransferase ◽  
Alcohol Intake ◽  
Mean Value ◽  
Hcv Rna ◽  
Before And After ◽  
The Mean

The World Health Organization (WHO) estimates that 170 million individuals worldwide are infected with hepatitis C virus (HCV). The aim of study was to evaluate possible correlations between METAVIR staging, the viral loads and alanine aminotransferase (ALT) levels in patients with chronic hepatitis C, before and after 12 weeks of treatment with PegInterferon a2a/a2b and Ribavirin. 93 consecutive patients with hepatitis C, were included in this study. The parameters followed were age, sex, Metavir histologic staging at the start of the treatment, hepatitis C virus ribonucleic acid (HCV-RNA) and ALT at start and after 12 weeks of treatment, as well as alcohol intake. The study group was composed by 58 women and 35 men, with a mean age of 44.47 � 11.17 years. At the beginning of the treatment, the mean value of HCV-RNA was 1327163 � 145001 UI/mL, with a CI95%=1327163 � 287986.36 UI/mL, and the mean value for ALT was 112.7124 � 68.7403 U/l. After 12 weeks of therapy, significant differences were found concerning both HCV-RNA and ALT values. HCV-RNA lowered to a mean value of 457.3978 � 402.653 (p[0.0001), while ALT lowered to a mean value of 37.90 � 16.43U/l (p[0.0001). Neither the initial HCV-RNA nor ALT values had any correlations with the METAVIR histological staging of the fibrosis. Initial ALT was higher in those with alcohol intake (p=0.000048). The ALT values instead, after 3 months of treatment, decreased significantly (p[0.0001), did correlate with the METAVIR groups (p=0.0019). The evolutionary stage of fibrosis didn�t correlate with gender of the patients or initial values of the HCV-RNA or ALT. There was no correlation between the age/gender of the patients and the determined METAVIR score.

The impact of chronic hepatitis C virus infection on survival in oropharyngeal cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17556-e17556
Author(s):  
Minas P. Economides ◽  
Erich M. Sturgis ◽  
Moran Amit ◽  
Jeff Hosry ◽  
Parag Mahale ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Proportional Hazards Model ◽  
Univariate Analysis ◽  
Hcv Infection ◽  
Cox Proportional Hazards Model ◽  
Oncologic Outcomes ◽  
Hcv Rna ◽  
Significant Difference ◽  
The Impact

e17556 Background: An association between Hepatitis C virus (HCV) infection and oropharyngeal cancers (OPCs) has been reported; however, the clinical significance of this epidemiological finding remains unknown. We therefore analyzed the oncologic outcomes of HCV-infected patients (pts) with OPCs. Methods: In this retrospective cohort study, all pts with OPCs seen at MD Anderson (1/2004-12/2015) were reviewed. HCV infection was defined as detectable HCV RNA in serum. Risk of 5-year (yr) overall survival (OS) and progression-free survival (PFS) was compared between HCV-infected (HCV+) and uninfected (HCV-) pts. OPCs that were positive for p16 by immunohistochemistry were considered HPV-related. Antiviral therapy (AVT) included either interferon (IFN)-based or IFN-free regimens. Multivariate cox proportional hazards model was used to identify independent predictors of mortality. Results: We studied 161 pts. Most of the pts were white (141; 88%), male (132; 82%) and had tumor stage 3 or 4 (147; 92%). The OPC involved tonsils (83; 52%), base of tongue (67; 42%) or soft palate (11; 7%). The median follow-up time after OPC diagnosis was 3 yrs (range: 1-13 yrs). HCV+ (n = 25) and HCV- pts (n = 136) were comparable in regards to smoking and alcohol status. In univariate analysis, HCV+ pts had more OPC progression after 1stline cancer treatment (48% vs 20.6% in HCV-, P = .0009) and were more likely to relapse (26% vs 5% in HCV-, P = .02). In multivariate analysis, HCV was associated with increased all-cause mortality [hazard ratio (HR): 2.15, 95% confidence intervals (CI): 1.08-6.85; P = .02] and risk of OPC progression [HR: 5.42, 95% CI: 2.64-11.14; P = .0008] independent of age and cirrhosis status. In HPV+ OPCs (n = 86), HCV + and HCV- pts did not have significant difference in mortality [HR: 2.03, 95% CI: 0.82-4.98; P = .12]. AVT was administered after OPC diagnosis in 8 of the 25 HCV+ pts (32%), with 6 of them receiving IFN-free AVT. HCV+ pts that received AVT had better 5 yr OS (median of 5.2 vs 2.3 yrs, P = .005) and PFS (median of 3.1 vs 0.7 yrs, P = .007) than the ones who did not. Conclusions: HCV seems to affect the oncologic outcomes of pts with OPCs and treating this infection might be beneficial. HCV screening and treatment should be considered in such pts.

scholarly journals Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A Practice Implication

2019 ◽  
Vol 71 (11) ◽  
pp. 2840-2848 ◽  
Author(s):  
Eiichi Ogawa ◽  
Hidenori Toyoda ◽  
Etsuko Iio ◽  
Dae Won Jun ◽  
Chung-Feng Huang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Large Population ◽  
Multivariable Analysis ◽  
Hcv Rna ◽  
Entire Study ◽  
Significant Difference ◽  
Using Data ◽  
Cure Rates

Abstract Background Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. Methods Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. Results We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. Conclusions Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.

scholarly journals Hepatitis C virus exposure rate among health-care workers in rural Lower Egypt governorates

2017 ◽  
Vol 5 (3) ◽  
pp. 164-168 ◽  
Author(s):  
Ashraf Elbahrawy ◽  
Ahmed Elwassief ◽  
Abdallah Mahmoud Abdallah ◽  
Arafat Kasem ◽  
Sadek Mostafa ◽  
...  
Keyword(s):  
Health Care ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Hcv Rna ◽  
Care Providers ◽  
Health Care Work ◽  
Care Workers ◽  
The Mean

Abstract Background and Objectives Studies on hepatitis C virus (HCV) in Egypt supported a strong role for various exposures in the health-care setting. In this study, we attempted to estimate the frequency of HCV exposure among Egyptian health-care workers (HCWs). Methods Five hundred and sixty-four (564) HCWs were included in this study. Two hundred and fifty-eight (45.74%) were health-care providers and 306 (54.25%) were non-health-care providers. All HCWs completed both the study questionnaire and provided a blood sample for anti-HCV testing by third-generation enzyme-linked immunosorbent assay. Subsequently, anti-HCV-positive samples were tested for HCV RNA using nested polymerase chain reaction (PCR). Results The mean age of included HCWs was 33.0 ± 9.8 years; of them, 319 (56.56%) were males and 245 (43.44%) were females. The mean duration of health-care work was 9.3 ± 6.7 years. The frequency of antibody against hepatitis C virus (anti-HCV) among included HCWs was 8.7% (n = 49). Old age and prolonged duration of health-care work were significantly associated with anti-HCV seropositivity. Forty (81.63%) of 49 with anti-HCV-positive HCWs had positive hepatitis C viremia. The frequency of HCV RNA positivity increased with age. The frequency of eradicated past infection among nurses (36.85%) was markedly higher than that (6.7%) detected in non-health-care providers. Conclusion High rate of HCV infection is detected in Egyptian HCWs in rural Lower Egypt governorates. Health-care providers seem to eradicate HCV infection more frequently than non-health-care providers. National screening and treatment of infected HCWs are recommended.

scholarly journals Hepatitis C Virus Core Antigen as an Alternative to RNA in the Assessment of Response to Treatment with Direct-acting Oral Antivirals

2021 ◽  
Vol 21 (9) ◽  
Author(s):  
Antonio Mancebo Martínez ◽  
Paula N&uacute;&ntilde;ez Serrano ◽  
José Carlos Fernández de Cañete Camacho ◽  
José María Moreno Planas
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Strong Correlation ◽  
Predictive Value ◽  
Core Antigen ◽  
Hcv Rna ◽  
Molecular Testing ◽  
The Mean ◽  
Direct Acting ◽  
Rna Levels

Background: Affordable and effective diagnostic and treatment monitoring algorithms are urgently needed to achieve the global elimination of hepatitis C virus (HCV) infection. Methods: A total of 274 patients were treated with direct-acting antivirals (DAAs) in the Spanish Hospital of Albacete between 2004 and 2020. This study compared the enzyme-immunoassay technique for HCV core antigen (HCVcAg) with the determination of RNA of HCV (HCV RNA) by polymerase chain reaction (PCR) in monitoring treatment with DAA, setting the lower limit of detection of HCVcAg < 3 fmol/L and RNA < 10 IU/mL. In all cases, the P value of differences associated with the contrast test was less than or equal to 0.05. Results: We evaluated the viral loads of our patients before treatment, during their treatment, and after its completion. The HCV RNA quantification at diagnosis was 2309327 IU/mL. The mean HCVcAg load was 5972 fmol/L. There was a strong correlation between HCVcAg levels and RNA levels with a Spearman rho of 0.832 (P < 0.01). The HCVcAg sensitivity at diagnosis was 99%, but the specificity could not be calculated because there were no true negatives or false positives at this point. Twelve weeks after treatment, in patients with treatment failure, we obtained a mean of 19084 IU/mL for RNA, while for HCVcAg, the mean was 103 fmol/L. At this time point, we also found a strong correlation between HCVcAg levels and HCV RNA levels with a Spearman rho of 0.775 (P < 0.01). Finally, the virological cure was achieved in 99% of our patients. The results for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100%, 99.87%, 86.33%, and 100%, respectively. Conclusions: HCVcAg determination is an excellent alternative to HCV RNA in the assessment of treatment response. This is particularly relevant in lower- and middle-income countries and resource-limited settings where the high cost of labor, equipment, and reagents can prohibit molecular testing.

scholarly journals Sofosbuvir-Based Therapies for Patients with Hepatitis C Virus Infection: Real-World Experience in China

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Chengguang Hu ◽  
Guosheng Yuan ◽  
Junwei Liu ◽  
Huaping Huang ◽  
Yanyu Ren ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Real World ◽  
Chinese Patients ◽  
Hcv Rna ◽  
Success Rates ◽  
Ns5b Polymerase Inhibitor ◽  
Significant Difference

Background and Aims. There is scarcity of data in literature regarding the treatment response to sofosbuvir- (SOF-) based therapies in Chinese patients with chronic Hepatitis C Virus (HCV) infection. The aim of this study was to evaluate the efficacy and safety of SOF-based regimens for chronic hepatitis C (CHC) patients without cirrhosis in a real-world setting in mainland China.Methods. A total of 226 patients receiving SOF plus daclatasvir (DCV), ledipasvir (LDV), or velpatasvir (VEL) were enrolled from December 2014 to June 2017. The primary observation point was the percentage of patients with a sustained virologic response (SVR) at posttreatment week 12 (SVR12), and all adverse events were monitored during treatment and follow-up period.Results. The overall SVR12 rate was 96% (216/226), and individual SVR12 ranged from 93% to 100% in different treatment groups. No significant differences of efficacy were detected between genotypes 1b and 6a (98% for GT 1b versus 100% for GT 6a, P=0.322). Comparing the high success rates in GT 1b and 6a patients, SVR12 was relatively low in GT 3a and 3b patients. A significant difference in efficacy was observed between GT 3 and not GT 3 patients (77% versus 98%, respectively, P<0.001). No significant differences in efficacy were detected among different regimens (93% versus 97% versus 100%, respectively, P=0.153), gender (95% for male versus 96% for female, P=0.655), or baseline HCV RNA lever (96% versus 95%, respectively, P=0.614). Similar SVR rates were also obtained in naïve and previously treated patients (98% versus 93%, respectively, P=0.100).Conclusions. NS5B polymerase inhibitor SOF plus one of the NS5A inhibitors, such as DCV, LDV, or VEL for 12 weeks was associated with high SVR12 rates and well tolerated in HCV-infected patients without cirrhosis. Moreover, patients with DAAs failure should be retreated with more effective regimens like SOF/VEL.

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