title: Sofosbuvir based therapy in hepatitis C patients with and without cirrhosis: Is there difference?
abstract: OBJECTIVE
  To compare sustained viral response to sofosbuvir/ribavirin ±interferon therapy in patients of hepatitis C with and without liver cirrhosis.
  
  
  METHODS
  This observational study of chronic hepatitis C patients was carried out at Doctors Hospital and Medical Center (DH&MC). After diagnostic workup, Sofosbuvir/ribavirin for 24 weeks or sofosbuvir/ribavirin/pegylated interferon for 12 weeks were prescribed. Primary outcome was negative HCV RNA by PCR 12 weeks after treatment completion (SVR12). Chi square χ2and student's t test were used to analyze data.
  
  
  RESULTS
  Of 216 patients included, liver cirrhosis was present in 112 (51.9%) patients and 69(31.9%) were treatment experienced. Liver disease was decompensated in 37 (17.1%) patients. Of 206 patient who completed study protocol, 173(83.1%) achieved SVR12, 89.2% (25/28) with triple therapy and 82.2% (148/180) with sofosbuvir/ribavirin therapy. Treatment response was similar between treatment naïve 86.2% (119/138) and treatment experienced 79.4% (54/68) patents. (p value 0.19) SVR12was inferior in cirrhosis patients 75.4% (80/106) as compared to those with no cirrhosis 93% (93/100) (p value < 0.000). It was even lesser in those with decompensated liver disease 68.8% (24/35) (p value < 0.000).
  
  
  CONCLUSIONS
  Treatment outcome with sofosbuvir/ribavirin combination therapy in cirrhosis patients is suboptimal especially in those with decompensation as compared to patients without liver cirrhosis.
authors.affiliation: Dr. Shahid Sarwar, MBBS, FCPS (Med), FCPS (Gastroenterology), MCPS-HPE, Associate Professor of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan. Department of Gastroenterology, Doctors Hospital and Medical Center (DH&MC), Lahore, Pakistan.
authors.forename: Shahid
authors.initials: S
authors.lastname: Sarwar
authors.affiliation: Dr. Anwaar A. Khan, ABIM, ABIM (GE), MACP, FACG, FRCP, AGAF, FCPS. Ex-Dean and Chairman Shaikh Zayed Hospital, Consultant Gastroenterologist, Doctors Hospital and Medical Center, Department of Gastroenterology, Doctors Hospital and Medical Center (DH&MC), Lahore, Pakistan.
authors.forename: Anwaar A
authors.initials: AA
authors.lastname: Khan
keywords: Chronic hepatitis C; Cirrhosis of liver; Sofosbuvir; Sustained viral response