Efficacité et tolérance des antiviraux à action directe dans le traitement de l’hépatite C au CHU Joseph Raseta Befelatanana d’Antananarivo, Madagascar

Objective. Our work aimed to assess the efficacy and safety of direct-acting antiviral drugs in the treatment of hepatitis C in Madagascar. Methods. This retrospective clinical study was carried out from March 2018 to February 2020 in the hepato-gastro-enterology department of the University Hospital Center Joseph Raseta de Befelatanana. Results. A total of 35 patients were included, out of which 24 received sofosbuvir/ledipasvir ± ribavirin, 10 sofosbuvir/ribavirin and one sofosbuvir/velpatasvir. Thirty-three patients were naive to the treatment and 2 patients were initially treated with the sofosbuvir/ledipasvir combination. The sustained virologic response was 94 % (33/35) in the general population, 23/25 in cirrhotic patients and 10/10 in non-cirrhotic patients. The sustained virologic response was 22/24 for sofosbuvir/ledipasvir ± ribavirin, 10/10 for sofosbuvir/ribavirin and 1/1 for sofosbuvir/velpatasvir. Adverse effects were observed in 13 patients, mainly asthenia and insomnia. Discussion. The small number of patients with hepatitis C treatments and their limited financial resources are the main limits of this survey. Conclusion. Direct-acting antivirals are effective and characterized by good tolerance in these Malagasy hepatitis C patients. Key Words: Viral hepatitis C, Direct-acting antiviral drugs, Hospital, Antananarivo, Madagascar, Indian Ocean