Hepatitis C Virus Infection in the PERSIAN Guilan Cohort Study Population: Intrafamilial Transmission Incidence and Response to SOVODAK‐Based Therapy

Background Hepatitis C virus (HCV) infection is one of the leading causes of liver‐related diseases such as cirrhosis and hepatocellular carcinoma. Despite ongoing efforts, no effective vaccine has been developed to date due to the virus's high mutation rate and extensive genetic variability. This study aimed to determine the prevalence of HCV infection among family members of HCV‐positive index cases, within related risk factors in them. Additionally, the study evaluated the therapeutic efficacy of the combination drug Sovodak (sofosbuvir–daclatasvir) based on HCV genotype. Methods This study is a descriptive cross‐sectional study conducted on the families of individuals with Hepatitis C (12 people) within the Guilan cohort population. Twenty family members of HCV‐positive individuals were enrolled. Data were collected using structured questionnaires that included socio‐demographic and clinical information. Blood samples were drawn from each participant, and sera were separated for serological analysis. HCV antibody‐positive samples were assessed by HCV‐RNA detection. Subsequently, positive samples underwent HCV genotyping. Then, HCV‐positive individuals were referred in Phase 3 clinical trial with ID: NCT03200184. for treatment and follow‐up. Treatment consisted of Sovodak (a combination of sofosbuvir 400 mg and daclatasvir 60 mg). The clinical and diagnostic effectiveness of the treatment was evaluated 12 weeks after therapy initiation. Results Out of the total cases, two were HCV antibody positive, and one of them was a 13‐year‐old girl who tested positive for HCV RNA by PCR. Her genotype was 1a, which matched her mother's genotype. This patient was successfully treated with Sovodak. The post‐treatment HCV RNA results were negative, indicating a sustained virologic response (SVR = 12). Conclusion Evidence of intrafamilial transmission was observed in this study, its frequency was extremely low and statistically negligible. Shared household items, although seemingly unlikely, such as toothpaste, may serve as a potential route of transmission within families, independent of direct interpersonal contact.