Direct antivirals for the treatment of chronic hepatitis C virus infection. Experience in 106 patients
Background: The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile. Aim: To report the initial experience of patients treated with DAA and their evolution after treatment. Material and Methods: Prospective...
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2017 |
| Country: | Chile |
| Institution: | Agencia Nacional de Investigación y Desarrollo |
| Repository: | Articulos_ANID |
| Language: | English |
| OAI Identifier: | oai:repositorio.anid.cl:10533/252651 |
| Online Access: | https://hdl.handle.net/10533/252651 |
| Access Level: | Open access |
| Keyword: | Ciencias Médicas y de la Salud Medicina Clínica |
| Summary: | Background: The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile. Aim: To report the initial experience of patients treated with DAA and their evolution after treatment. Material and Methods: Prospective cohort study, from June 2013 to August 2016 of patients treated with DAA for HCV in three clinical centers. The presence of cirrhosis, clinical and laboratory features; adverse events (AE) and post-treatment changes in liver function were evaluated. Sustained viral response at 12 weeks post-treatment (SVR12) was determined. Results: One hundred six patients aged 58 +/- 13 years, 54% males, were included. HCV genotype 1b was present in 88% and 47% had cirrhosis. Treatment regimens were asunaprevir + daclatasvir (DCV) in 17% of patients, paritaprevir / ritonavir / ombitasvir + dasabuvir in 33%, sofosbuvir (SOF) + DCV in 19%, and SOF + ledipasvir in 30%. Twenty five percent of patients used generic drugs. SVR12 was 92.1%, with no differences between generic and brand-name drugs. Serious AE were recorded in 22% of patients, being more common in those with cirrhosis (34% vs 11.5%, p < 0.01). At 12 weeks post-treatment follow-up, there was a decrease in aminotransferase values (p < 0.01), improvement in Child-Pugh score (5.9 vs. 5.5, p = 0.03) and decreased presence of ascites (p = 0.02). Conclusions: In our setting, DAA for HCV was highly effective and safe in non-cirrhotic patients. Hepatic function and inflammation improved at 12 weeks of follow-up. AE were common in patients with cirrhosis, suggesting that these patients should be treated by experienced teams. Generic drugs had similar effectiveness compared to originals. Keywords. Author Keywords:Antiviral Agents; Chile; Drugs, Generic; Fibrosis; Hepatitis C; Latin America . KeyWords Plus:SUSTAINED VIROLOGICAL RESPONSE; HEPATOCELLULAR-CARCINOMA; CIRRHOSIS; RECURRENCE; THERAPY |
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