The efficacy of new treatment methods in HCV patients: a single center study

The efficacy of new treatment methods in HCV patients: a single center study

ABSTRACT Aim: Achieving sustained virologic response (SVR) is critical in patients with chronic hepatitis C virus (HCV) infection. Over the last few years, many developments have been made in HCV infection treatment with the evaluation of direct-actinga antivirals (DAAs). Treatment with DAAs resulted in high rates of SVR among patients with chronic HCV infection.   The aim of our study aim to compare the treatment efficacy between different DAA regimens in patients with HCV. Methods: In our study 290 patients were evaluated retrospectively with regard to the effects related to the use of DAAs and its effects on HCV-RNA. The primary end point was a SVR at 12 weeks after the end of the DAA therapy. Results: In our study included 290 patients who were treated with DAA. The rate of SVR was 99% (98%; 95 confidence interval [CI], 96 to 100) with 12 weeks of ledipasvir plus sofosbuvir (LDV+SOF), 96% (97.9%; 95% CI, 94 to 99) with 12 weeks of sofosbuvir plus ribavirin (SOF+RBV), and 90% (98.9%; 95% CI, 95 to 99) with 12 weeks of ombitasvir/paritaprevir/ritonavir plus dasabuvir (PrOD). In comparing LDV+SOF, SOF+RBV and PrOD, the chance of having SVR between these three DAA regimens was not significantly different. Conclusion: DAA treatment regimens should be preferred in the first line drug for the treatment of chronic HCV infection because of the their significant clinical benefits.

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  • REFERENCES 1. World Health Organization. Guidelines for the Screening, Care and Treatment of Persons with Hepatitis C Infection. Geneva: World Health Organization; 2014. 2. Smith BD, Morgan RL, Beckett GA, et al; Centers for Disease Control and Prevention. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR Recomm Rep. 2012;61(RR-4):1–32. 3. Ghany MG, Strader DB, Thomas DL, et al. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology (Baltimore, Md). 2009;49: 1335–1374. 4. Negro F, Alberti A. The global health burden of hepatitis C virus infection. Liver Int. 2011;31(Suppl 2:):1–3. 5. Bruno S, Stroffolini T, Colombo M, et al. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study. Hepatology (Baltimore, Md). 2007;45: 579–587. 6. Veldt BJ, Heathcote EJ, Wedemeyer H, et al. Sustained virologic response and clinical outcomes in patients with chronic hepatitis C and advanced fibrosis. Ann Intern Med. 2007;147: 677–684. 7. European Association for Study of Liver. EASL Clinical Practice Guidelines: management of hepatitis C virus infection. J Hepatol 2014; 60: 392-420. 8. American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. Recommendations for testing, managing, and treating hepatitis C. (Updated July 7, 2014, accessed June 23, 2015). 9. Lawitz E, Lalezari JP, Hassanein T, et al. Sofosbuvir in combination with peginterferon alfa-2a and ribavirin for non-cirrhotic, treatment-naive patients with genotypes 1, 2, and 3 hepatitis C infection: A randomised, double-blind, phase 2 trial. The Lancet Infectious Diseases. 2013; 13(5):401–8. 10. Lawitz E, Sulkowski MS, Ghalib R, et al: Simeprevir plus sofosbuvir, with or without ribavirin, to treat chronic infection with hepatitis C virus genotype 1 in non-responders to pegylated interferon and ribavirin and treatment-naive patients: the COSMOS randomised study. Lancet 2014; 15: pp. 1756-1765. 11. Kwo P, Gitlin N, Nahass R, et al: Simeprevir plus sofosbuvir (12 and 8 weeks) in hepatitis C virus genotype 1-infected patients without cirrhosis: OPTIMIST-1, a phase 3, randomized study. Hepatology 2016; 64: pp. 370-380. 12. Nelson DR, Cooper JN, Lalezari JP, et al: All-oral 12-week treatment with daclatasvir plus sofosbuvir in patients with hepatitis C virus genotype 3 infection: ALLY-3 phase III study. Hepatology 2015; 61: pp. 1127-1135. 13. Kohli A, Shaffer A, Sherman A, et al. Treatment of hepatitis C: a systematic review. Jama.2014; 312(6):631–40. 14. Feeney ER, ChungRT. Antiviral treatment of hepatitis C. BMJ(Clinicalresearched). 2014;348. 15. Jacobson IM, McHutchison JG, Dusheiko G, et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med 2011;364: 2405-16. 16. Poordad F, McCone J Jr, Bacon BR, et al. Boceprevir for untreated chronic HCV genotype 1 infection. N Engl J Med 2011; 364:1195-206. 17. Ghany MG, Nelson DR, Strader DB, et al. An update on treatment of genotype 1 chronic hepatitis C virus infection: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology 2011;54: 1433-44. 18. Afdhal NH, Dusheiko GM, Giannini EG, et al. Eltrombopag increases platelet numbers in thrombocytopenic patients with HCV infection and cirrhosis, allowing for effective antiviral therapy. Gastroenterology 2014;146: 442-52. 19. Bacon BR, Gordon SC, Lawitz E, et al. Boceprevir for previously treated chronic HCV genotype 1 infection. N Engl J Med 2011;364: 1207-17. 20. Zeuzem S, Andreone P, Pol S, et al. Telaprevir for retreatment of HCV infection. N Engl J Med 2011;364: 2417-28. 21. Hézode C, Fontaine H, Dorival C, et al. Triple therapy in treatment- experienced patients with HCV-cirrhosis in a multicentre cohort of the French Early Access Programme (ANRS CO20CUPIC) — NCT01514890. J Hepatol 2013; 59:434-41. 22. Cooper C, Lester R, Thorlund K, et al. Direct-acting antiviral therapies for hepatitis C genotype1infection: a multiple treatment comparison meta-analysis. QJM: monthly journal of the Association of Physicians. 2013;106(2):153–63. 23. Welzel TM, Hinrichsen H, Sarrazin C, et al. Real-world experience with the all-oral, interferon-free regimen of ombitasvir/paritaprevir/ritonavir and dasabuvir for the treatment of chronic hepatitis C virus infection in the German Hepatitis C Registry. J Viral Hepat. 2017 Oct;24(10):840-849. 24. Deterding K, Spinner CD, Schott E, et al. Ledipasvir plus sofosbuvir fixed-dose combination for 6 weeks in patients with acute hepatitis C virus genotype 1 monoinfection (HepNet Acute HCV IV): an open-label, single-arm, phase 2 study. Lancet Infect Dis. 2017 Feb;17(2):215-222. 25. Feld JJ, Kowdley KV, Coakley E, et al. Treatment of HCV with ABT-450/r-ombitasvir and dasabuvir with ribavirin. N Engl J Med. 2014 Apr 24;370(17):1594-603. 26. K Bayan, MK Celen, T Dal, et al. Ombitasvir/Paritepravir/Ritonavir Plus Dasabuvir Treatment Experience In HCV Patients. Acta Medica Mediterranea, 2018, 34: 71.