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Madiha Khalid
Abdul Rauf
Sadia Mumtaz
Aisha Siddique
Zeeshan Anjum


HCV, Untypable isolates, DAAs, Sofosbuvir, Ribavirin, Daclatasvir, Drug response, RVR, SVR, EOT


An increased prevalence of diagnostically untypable HCV isolates has been reported for the past few years in Pakistan and the efficacy of DAA-based treatment regimens can be significantly affected by HCV genotypes and subtypes. The Current study aimed to evaluate the drug response of diagnostically untypable isolates to existing DAA based treatment regimens in Pakistan. Drug response was evaluated by an observational study including 192 patients infected with an untypable genotype with 101 patients receiving Sofosbuvir-Daclatasvir (SOF-DCV) and 91 receiving Sofosbuvir-Ribavirin (SOF-RBV) for 12 weeks and by monitoring Rapid virologic response (RVR) at 4 weeks of initiating therapy, end of treatment (EOT) response at 12 weeks and sustained virologic response at 12 weeks (SVR12) after EOT. Overall, SVR12 of untypable genotypes against the current treatment regimen was 83.3% (160/192). The untypable genotype responded significantly well to SOF-DCV as compared to SOF-RBV with an SVR12 rate of 91.0% and 74.7% respectively. The proportion of non-responders to SOF-DCV (6.9%) was significantly less as compared to non-responders to SOF-RBV (19.7%). Also, relapse rates were significantly high in the group treated with SOF-RBV (5.4%) as compared to SOF-DCV (1.9%) (p<0.05). Efficacy of both regimens varied significantly with age (p>0.05) but did not vary with gender. A Pangenotypic SOF-DCV treatment regimen is found as an effective regimen for these circulating untypable genotypes.


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