{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T07:54:54Z","timestamp":1764402894186,"version":"3.40.5"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We investigated tolerability and effectiveness of generic, less expensive direct antiviral drugs in the treatment of hepatitis C virus genotype 4 (HCV GT\u20104) in an Egyptian cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Retrospectively, we analysed data from 648 patients with HCV GT4 attending Alexandria Main University Hospital from January 2016 to May 2017 [488 treatment na\u00efve\/160 treatment\u2010experienced\/288 with chronic hepatitis\/360 with cirrhosis]. Patients received generic sofosbuvir\/ledipasvir (n\u00a0=\u00a0168, treatment na\u00efve\u00a0=\u00a0136, treatment\u2010experienced\u00a0=\u00a032) or sofosbuvir\/daclatasvir (n\u00a0=\u00a0480, treatment na\u00efve\u00a0=\u00a0352, treatment\u2010experienced\u00a0=\u00a0128) \u00b1 ribavirin. We assessed sustained virologic response 12\u00a0weeks after treatment, non\u2010response, relapse, treatment discontinuation and drug adverse reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>An overall sustained virologic response 12\u00a0weeks after treatment was achieved in 97.8%, non\u2010response in 0.6%, relapse in 0.3% and discontinuation of treatment in 1.3% of patients. Sofosbuvir\/ledipasvir \u00b1 ribavirin regimen attained an overall sustained virologic response 12\u00a0weeks after treatment in 96.4% of patients (100% of treatment\u2010experienced vs 95.6% of treatment na\u00efve, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.28), vs 98.3% for sofosbuvir\/daclatasvir \u00b1 ribavirin regimen (100% of treatment\u2010experienced vs 97.7% of treatment na\u00efve, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.08). No severe drug adverse events or deaths were reported except anaemia due to ribavirin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Generic direct antiviral drugs used in treating Egyptian patients with HCV GT\u20104 demonstrated equal potency, safety and tolerability compared to original brands, with low cost which would help to provide treatment to a larger scale of patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14022","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T13:19:48Z","timestamp":1544793588000},"page":"835-843","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Tolerability and effectiveness of generic direct\u2010acting antiviral drugs in eradication of hepatitis C genotype 4 among Egyptian patients"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8599-1338","authenticated-orcid":false,"given":"Sameh A.","family":"Lashen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Faculty of Medicine University of Alexandria Alexandria Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed M.","family":"Shamseya","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Internal Medicine Medical Research Institute Alexandria University Alexandria Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwa A.","family":"Madkour","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Internal Medicine Medical Research Institute Alexandria University Alexandria Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galal A.","family":"Aboufarrag","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine Faculty of Medicine Al\u2010Azhar University Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27248"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.07.027"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aidm.2016.03.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1186\/s13027-017-0119-8","article-title":"Safety of new DAAs for chronic HCV infection in a real\u2010life experience: the role of a surveillance network based on clinician and hospital pharmacist","volume":"12","author":"Nappi A","year":"2017","journal-title":"Infect Agent Cancer"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2017.1240781"},{"key":"e_1_2_9_7_1","first-page":"835","article-title":"Hepatitis C in Egypt \u2010 past, present, and future","volume":"10","author":"Elgharably A","year":"2017","journal-title":"Int J Gen Med"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.12668"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.03.025"},{"key":"e_1_2_9_10_1","first-page":"118","article-title":"Model for End\u2010stage Liver Disease (MELD) and Child\u2010Turcotte\u2010 Pugh (CTP) scores: ability to predict mortality and removal from liver transplantation waiting list due to poor medical conditions","volume":"17","author":"Rahimi\u2010Dehkordi N","year":"2014","journal-title":"Arch Iran 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ONE"},{"key":"e_1_2_9_19_1","unstructured":"Central Agency for Public Mobilization and Statistics.Egypt statistics[Internet].Availablefrom:http:\/\/www.capmas.gov.eg\/Pages\/IndicatorsPage.aspx?page_xml:id=6154&ind_xml:id=1124[Accessed 16th September 2018]."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.07.004"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170933"}],"container-title":["Liver 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