Hepatitis C virus infection: Epidemiology in Egypt, Pathophysiology and DAAs-based therapy

Document Type : Review Article

Authors

1 Faculty of Pharmacy Ain Shams University

2 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt

Abstract

Hepatitis C virus (HCV) was first identified in 1989. The situation in Egypt is really dire. The prevalence of HCV genotype 4 (GT-4) is 14.7%. About 10% of the middle-aged population (ages 15 to 59) is infected with HCV. As a result, the Hepatitis C virus is considered extremely contagious. The introduction of the directly acting antiviral medications (DAAs), sofosbuvir or simeprevir, in GT-4 patients with PEGylated interferon (PEG-IFN) and ribavirin (RBV) in a 12-week regimen substantially increased sustained virological response (SVR) rates for HCV GT-4 in 2014. Daclatasvir (DCV) is the first DAA identified in the family of HCV NS5A inhibitors with antiviral activity against a variety of HCV genotypes. It is well tolerated and safe, with a low risk of drug-drug interactions and resistance. Many investigations have discovered a rapid initial viral decline followed by a gradual decline in viral RNA, demonstrating DCV's inhibitory effect on viral reproduction, assembly, and secretion. DCV is a CYP3A4 substrate as well as a substrate for P-glycoprotein (P-gp), the most common drug efflux transporter, which are both expressed in hepatocytes and enterocytes, however it is not a BCRP substrate (Breast Cancer Resistence Protein). Concomitant treatment of DCV with other medications targeting CYP3A4 or P glycoprotein may change its pharmacokinetic characteristics.

Keywords

Archives of Pharmaceutical Sciences Ain Shams University
Volume 5, Issue 2
December 2021
Pages 234-248

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