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Background: Direct-acting antivirals (DAAs) are welltolerated drugs for the treatment of chronic hepatitis C infection (CHC). We aimed to assess the patient compliance during DAAs treatment of CHC. Materials and Methods: The study included 371 CHC patients commencing DAAs therapy. The socioeconomic status of patients was assessed at index time. Three questions were asked to all patients to determine their attitude towards DAAs. All patients were asked at each visit about drug adherence and side effects using a questionnaire. Adherence was measured using two equations; the first was Continuous, Single Interval Measure of Medication Gaps (CSG) = Number of days without any medication/total days in the interval and the second was, Pill count = (Number of dosage units dispensed-number of dosage units remained)/ (prescribed number of dosage unit per day× number of days between 2 visits). Results: Out of 371 patients included in the study only, 368 patients continued the study divided into two groups; group (A) included 184 patients received (Sofosbuvir plus Daclatasvir) and group (B) included 184 received (Sofosbuvir plus Daclatasvir and Ribavirin). The adherence to DAAs was 99% in group A versus 100% in group B with no significant difference in CSG, pill count, and several days with improper timing of dosage between the two groups. The common side effects noticed in both groups were fatigue and headache. Conclusions: Treatment of chronic hepatitis C infection, using Sofosbuvir plus Daclatasvir with or without Ribavirin, is well tolerated with very high adherence and few side effects. Introduction Chronic hepatitis C virus (HCV) infection is a universally prevalent pathogen leading to liver cirrhosis and liver cancer . Hepatitis C viral infection is endemic in Egypt with the highest prevalence rate in the world 3, . Until recently, the standard of care for treatment of chronic hepatitis Chas included a combination of pegylated interferon and ribavirin, administered to the patients for 24 to 48 weeks, according to HCV genotype with sustained virological response (SVR) rate nearly about 50% . Approval of direct-acting antivirals (DAAs) substantial progress in the treatment of hepatitis C virus 6, . The new interferon-free direct-acting antiviral-based regimens reportedly have a substantially higher efficacy rate with minimal side effects and excellent adherence . Adherence is defined as; the extent to which the patient’s behavior with drug administration matches the agreed recommendation from the prescriber. This refers to a process, in which the appropriate treatment is decided after a proper discussion with the patient . Adherence to drugs is associated with high SVR rates. In contrast, suboptimal exposure to therapy is associated with biological breakthrough or post-treatment relapse and the emergence of resistance-associated variants, especially during the early phase of treatment . Evaluating adherence to DAAs regimens is vital to translating the high efficacy of these regimens. In particular, adherence is important to attaining the maximal rate of SVR from a treatment regimen, avoiding treatment failure and /or the development of DAAs resistance . There are many factors affecting drug tolerability and adherence such as co-morbid depression, poor access to health care, limited or no insurance coverage, drug, and alcohol abuse . This study aims to evaluate patient compliance during treatment of CHC using (Sofosbuvir plus Daclatasvir) with or without Ribavirin and to determine possible causes of non-compliance. Materials and methods This prospective observational cohort study included 371 patients with chronic hepatitis C. The patients aged more than 18 years from Mansoura Specialized Medical Hospital (Virology Outpatient Clinic) from April 2017 to March 2018. Patients were divided into two groups based on anti-viral therapy given according to the National treatment program in Egypt . Inclusion criteria: 1. Patients with CHC eligible for DAAs treatment. 2. Child-Turcotte Pugh class (A). 3. Patients aged ≥ 18 years.

Assessment of Patient Compliance during treatment of chronic hepatitis C infection using Sofosbuvir and Daclatasvir with or without Ribavirin.