Making sense of ‘side effects’: Counterpublic health in the era of direct-acting antivirals

2019 ◽  
Vol 72 ◽  
pp. 77-83 ◽  
Author(s):  
Joanne Bryant ◽  
Jake Rance ◽  
Peter Hull ◽  
Limin Mao ◽  
Carla Treloar
Keyword(s):  
Side Effects ◽  
Direct Acting Antivirals ◽  
Making Sense ◽  
Direct Acting

scholarly journals Remission of long-term hepatic and renal disease induced by HCV after direct-acting antivirals therapy

2020 ◽  
Author(s):  
Raissa M Arruda ◽  
Andrea D Batista ◽  
Norma A Filgueira ◽  
Izolda F Moura ◽  
Luis H Sette ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Side Effects ◽  
Renal Diseases ◽  
Direct Acting Antivirals ◽  
Direct Acting ◽  
Autoimmune Phenomena

Abstract In addition to liver disease, the hepatitis C virus (HCV) has been associated with autoimmune phenomena, such as mixed cryoglobulin and glomerulonephritis (GN). Until recently, both chronic hepatitis and HCV extra-hepatic manifestations were treated with peg-interferon plus ribavirin, however these drugs presented low efficacy and induced severe side effects. Nowadays, the HCV chronic hepatitis has been treated with direct acting antivirals (DAA), but studies on the DAA therapy for HCV-associated glomerulonephritis are scarce. Here, we describe two cases of HCV-associated glomerulonephritis that were treated with DAAs. In these two cases, previously experienced to peg-interferon plus ribavirin, the sofosbuvir plus simeprevir therapy was effective, without significant side effects, and interrupted the evolution of at least 20 years of both hepatic and renal diseases. These cases join the seven previously described cases that were treated with this DAAs association.

scholarly journals Dermatological side effects of hepatitis C and its treatment: Patient management in the era of direct-acting antivirals

2012 ◽  
Vol 56 (2) ◽  
pp. 455-463 ◽  
Author(s):  
Patrice Cacoub ◽  
Marc Bourlière ◽  
Jann Lübbe ◽  
Nicolas Dupin ◽  
Peter Buggisch ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Side Effects ◽  
Patient Management ◽  
Direct Acting Antivirals ◽  
Treatment Patient ◽  
Direct Acting ◽  
Dermatological Side Effects

Metabolism of Direct-Acting Antiviral Agents (DAAs) in Hepatitis C Therapy: A Systematic Review

2020 ◽  
Vol 21 ◽  
Author(s):  
Ivana Mikolasevic ◽  
Tajana Filipec Kanizaj ◽  
Dorotea Bozic ◽  
Petra Puz ◽  
Sanja Stojsavljevic ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Side Effects ◽  
Drug Interactions ◽  
Hcv Infection ◽  
Direct Acting Antivirals ◽  
Direct Acting Antiviral ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting

Background:: Hepatitis C virus (HCV) infection is still one of the leading causes of chronic liver disease with chronically infected making up approximately 1% of the global population. Of those infected, 70% (55-85%) will develop chronic HCV infection. Chronic HCV infection causes substantial morbidity and mortality, with complications including cirrhosis, end-stage liver disease, hepatocellular carcinoma, and eventually death. Objective:: Therapeutic options for chronic HCV infection have evolved dramatically since 2014, with a translation from pegylated interferon and ribavirin (associated with suboptimal cure and high treatment-related toxicity) to oral direct-acting antiviral treatment. There are four classes of direct-acting antivirals which differ by their mechanism of action and therapeutic target. They are all pointed to proteins that form the cytoplasmic viral replication complex. Multiple studies have demonstrated that direct-acting antiviral therapy is extremely well tolerated, highly efficacious, with few side effects. Methods:: We performed an indexed MEDLINE search with keywords regarding specific direct-acting antiviral regimes and their pharmacokinetics, drug drug interactions, and metabolism in specific settings of pregnancy, lactation, liver cirrhosis, liver transplantation and HCC risk, kidney failure and kidney transplantation. Results:: We present a comprehensive overview of specific direct-acting antivirals metabolism and drug drug interaction issues in different settings. Conclusion:: Despite its complex pharmacokinetics and possibility of drug drug interactions, direct-acting antivirals extremely high efficacy in providing viral clearance is an obvious advantage compared to possible interactions or side effects. They should be administered cautiously in patients with other comorbidities, and with a tight control of immunosuppressive therapy.

scholarly journals Diagnostic approach to elucidate the efficacy and side effects of direct-acting antivirals in HCV infected patients

2021 ◽  
Vol 15 (10) ◽  
pp. 1489-1496
Author(s):  
Sonia Younas ◽  
Hamid Mukhtar ◽  
Umar Farooq Gohar ◽  
Abdullah Alsrhani ◽  
Badr Alzahrani ◽  
...  
Keyword(s):  
Side Effects ◽  
Molecular Techniques ◽  
Baseline Viral Load ◽  
Hcv Rna ◽  
Efficacy Rate ◽  
Direct Acting Antivirals ◽  
Genotype 3 ◽  
Hcv Genotype ◽  
Hcv Genotype 3 ◽  
Direct Acting

Introduction: The conventional interferon therapy of hepatitis C virus has been substituted substantially with sofosbuvir and daclatasvir due to constraints in efficacy and tolerability. This study aimed diagnostically to monitor the effectiveness and side effects of direct-acting antivirals in the management of HCV infections. Methodology: This prospective study was conducted on HCV-infected patients treated with sofosbuvir and daclatasvir. Different serological, biochemical, hematological, and molecular techniques were used for the assessment of patients. Only treatment-naive patients aged ≥ 18 to 75 years received 12 weeks of treatment. The primary endpoint was a sustained virologic response with undetectable HCV RNA in the patients’ serum at the end of the treatment. Results: We identified 229 cases of confirmed HCV infections by PCR, 94.3% of which had genotype 3. The study population comprised 66% females and 34% males with a median age of 42.2 ± 10.6 SD. Ninety-three percent of the patients accomplished SVR at week 12. The combined therapy of SOF/DAC achieved the highest efficacy rate (92.6%) among the different HCV genotype 3 patients. A statistically significant relationship was observed between low baseline viral load (p < 0.001; 95% CI = 1.2-3.1) and HCV genotype 3 with minor side effects, including lethargy, headache, nausea, insomnia, diarrhea, and fever. Conclusions: HCV-infected patients can be treated well with an interferon-free SOF/DAC regimen, tolerated with generally mild adverse effects with a higher SVR.

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