Gastroenterology, Hepatology & Digestive Disorders


Treatment of Hepatitis C with Direct Action Antivirals in Brazzaville, Congo

Ahoui Apendi CP, Mongo-Onkouo A, Itoua-Ngaporo NA, Mimiesse Monamou JF, Ngami RS, Aloumba GA, Ngalessami Mouakosso M, Adoua CS, Deby Gassaye, Atipo Ibara BI, Ibara J-R.

Introduction: In the Congo the prevalence of HCV infection is estimated between 3 and 5%. Before the advent of direct-acting antivirals, the care of patients infected with HCV was laborious. The aim of the study is to assess the virological response after 12 weeks of treatment with direct-acting antivirals.

Patients and Methods: This was a cross-sectional study conducted from January 1, 2016 to January 01, 2019. The study included patients with positive anti-HCV Ab and detectable HCV RNA treated with direct-acting antivirals. The quantification of the HCV-RNA was carried out by real-time RT-PCR Cobas 8000 Roche®. The evaluation of hepatic fibrosis was carried out by the fibro-Test or the fibroscan. Viremia was checked at 12 weeks and 24 weeks. The sustained virological response was defined by an undetectable viral load 12 weeks after the end of treatment.

Results: During the period, 58 patients were included, the sex ratio was 1. The average age was 50 with extremes of 25 to 81. Six patients had decompensated cirrhosis, two patients had failed with pegylated dual therapy. Genotype 4 was found in 47 of the patients, genotype 1 in seven of the patients; one patient had genotype 1 and 4 co-infection, two patients had genotype 2 and one patient did not have a genotype. The pre-therapeutic viral load was less than 5.90 log in 31 (54.3%) patients, greater than or equal to 5.90 log in 27 (46.6%) patients. The evaluation of hepatic fibrosis by fibrotest or fibroscan concluded in an F3-F4 fibrosis in 67.2%; 24.1% had F1-F2 fibrosis and 8.6% did not have fibrosis. The therapeutic combinations used were: Sofosbuvir-Ribavirin (5.2%) of the cases, SofosbuvirLédipasvir (51.7%), Sofosbuvir-Daclatasvir (3.4%) of the cases and Sofosbuvir-Velpatasvir (24.1%) of the cases case. The virological response was obtained in 99% of the cases. No side effects were observed.

Conclusion: Direct-acting antivirals are effective and well tolerated in the treatment of hepatitis C in our study.

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