Elbaz Tamer, Al-Naamani Khalid, Abosheaishaa Hazem, Alswat Khalid, El-Kassas Mohamed
Endemic Hepatology and Gastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Hepatology and Gastroenterology Department, Faculty of Medicine, New Giza University, Cairo, Egypt.
J Viral Hepat. 2025 Jul;32(7):e70032. doi: 10.1111/jvh.70032.
Chronic hepatitis C virus (HCV) management has historically been challenging, particularly in Egypt, the country with the highest global disease prevalence. The introduction of direct-acting antivirals (DAAs) has revolutionised treatment, providing high rates of sustained virologic response (SVR) with fewer adverse events compared to previous therapies. In Egypt, the locally produced generics of sofosbuvir/daclatasvir (SOF/DAC) have been integral to the national HCV elimination programme, treating millions effectively and affordably, demonstrating similar efficacy and safety to brand-name drugs. Although not currently present in most international guidelines, this cost-effective regimen offers a viable option for large-scale elimination programmes similar to Egypt's successful experience. This review synthesises real-world Egyptian data and highlights the efficacy and safety of the SOF/DAC combination in various population groups. High sustained virological response (SVR) rates were observed across diverse patient populations, including those with advanced liver disease. However, limitations regarding long-term follow-up, especially HCC surveillance, were identified, underscoring the need for further research. Additionally, the review underscores the success of local Egyptian pharmaceutical policies in reducing treatment costs and securing access for all infected individuals. The Egyptian experience offers valuable insights into the potential for replicating its success, particularly in other high-burden regions.
慢性丙型肝炎病毒（HCV）的管理一直以来都具有挑战性，在埃及尤其如此，该国是全球疾病患病率最高的国家。直接抗病毒药物（DAAs）的引入彻底改变了治疗方式，与以往疗法相比，其持续病毒学应答（SVR）率更高，不良事件更少。在埃及，索磷布韦/达卡他韦（SOF/DAC）的本地仿制药一直是国家丙型肝炎消除计划的重要组成部分，以有效且经济的方式治疗了数百万人，显示出与名牌药物相似的疗效和安全性。尽管目前大多数国际指南中没有提及，但这种具有成本效益的治疗方案为类似于埃及成功经验的大规模消除计划提供了一个可行的选择。本综述综合了埃及的真实世界数据，并强调了SOF/DAC组合在不同人群中的疗效和安全性。在包括晚期肝病患者在内的各种患者群体中均观察到了较高的持续病毒学应答（SVR）率。然而，研究发现了长期随访方面的局限性，尤其是肝癌监测方面，这突出了进一步研究的必要性。此外，该综述强调了埃及当地制药政策在降低治疗成本和确保所有感染者获得治疗方面的成功。埃及的经验为复制其成功的可能性提供了宝贵的见解，尤其是在其他高负担地区。
