SAT-229-Risk of hepatocellular carcinoma in patients with chronic hepatitis C and stage-3 liver fibrosis after sustained virological response with direct acting antivirals

2019 ◽  
Vol 70 (1) ◽  
pp. e731 ◽  
Author(s):  
Maria Sanchez-Azofra ◽  
Inmaculada Fernández Vázquez ◽  
Maria Luisa Garcia ◽  
Lourdes Dominguez ◽  
Conrado Fernández-Rodríguez ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Direct Acting Antivirals ◽  
Direct Acting

scholarly journals EFFICACY OF SOFOSBUVIR PLUS VALPATASVIR BASED THERAPY IN THE TREATMENT OF TREATMENT NAIVE CHRONIC HEPATITIS C GENOTYPE-3 IN KASHMIR.

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Shabir Shiekh ◽  
Shafat Lone ◽  
Zafar Wani ◽  
Zafar Kawoosa ◽  
Showkat A. Kadla
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Fixed Dose ◽  
Direct Acting Antivirals ◽  
Genotype 3 ◽  
Treatment Naïve ◽  
Direct Acting

Abstracts Objectives: Direct acting antivirals (DAAs) have dramatically changed our approach towards management of chronic hepatitis C by yielding a high sustained virological response (SVR). Genotype-3 is the most common genotype found in Kashmir (Northern India) besides having an aggressive nature with increased risk of steatosis and hepatocellular carcinoma. We assessed the efficacy and safety of sofosbuvir plus valpatasvir based therapy in chronic hepatitis C genotype-3 infection in Kashmiri population. Aims and objectives: An observational, prospective, open label, hospital based study was carried over a period of two years which included 230 treatment naïve chronic hepatitis-C genotype-3 patients. Patients were divided in two groups. Group-A: Non-cirrhotics who received sofosbuvir (400 mg daily) with valpatasvir (100 mg) in fixed–dose combination for 12 weeks. Group B included CPT class A cirrhotics who received sofosbuvir (400mg daily) with valpatasvir (100 mg daily) and weight based ribavarin for 12 weeks. The primary end point was a sustained virologic response at 12 weeks after the end of therapy. Results and observations: We observed 98.57 % (138/140) SVR 12 in non-cirrhotics who received valpatasvir plus sofosbuvir treatment regimen. Cirrhotics who received Sofosbuvir plus valpatasvir with ribavirin observed SVR of 96.6 % (87/90). All patients tolerated the drug regimens well without any serious adverse effect. Conclusion: Once daily oral Sofosbuvir plus valpatasvir based fixed dose rerimen is highly efficient and safe in treatment of both cirrhotics and non-cirrhotic hepatitis C patients. Keywords: Direct acting antivirals; sustained virological response; Genotype; chronic hepatitis C

scholarly journals ERADICATION OF HCV INFECTION IN PATIENTS WITH LIVER CIRRHOSIS: FACTOR OF CANCER PREVENTION OR CARCINOGENESIS?

2019 ◽  
Vol 18 (3) ◽  
pp. 90-96
Author(s):  
N. A. Malinina ◽  
N. V. Mazurchik ◽  
O. I. Tarasova ◽  
P. P. Ogurtsov
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Antiviral Drugs ◽  
Direct Acting Antiviral ◽  
Direct Acting

Hepatocellular carcinoma (HCC) is one of the most common causes of death from cancer and is the final stage of chronic liver disease, usually occurring in patients with cirrhosis (CP). Chronic infection with hepatitis C virus (HCV) leads to progressive liver inflammation and cirrhosis because this virus specifically affects liver tissue. Previously used interferon therapy had a relatively low efficiency and very high risks of side effects. During the period of administration of interferon (IFN) schemes it was proved that elimination of the virus significantly reduced risk of liver cancer development. Discovery of direct-acting antiviral (DAA ) drugs have revolutionized HCV therapy with virus elimination rate of more than 95 % and an excellent safety profile. However, the risk of transformation of liver cirrhosis into hepatocellular carcinoma is still high even after complete eradication of the virus. Numerous studies have shown conflicting results on the possible relationship between the use of new antiviral drugs and the increase in the frequency of newly diagnosed or recurrent hepatocellular carcinoma. Thus, the long-term prognosis in terms of risk for HCC development among patients with sustained virological response (SVR) remains unclear.The purpose of the study was to analyze the literature on the effect of antiviral therapy of chronic hepatitis C with interferon-containing regimens and drugs of direct antiviral action on the risk of developing or recurring hepatocellular carcinoma.Material and Methods. We analyzed publications available from PubMed, S copus, E-library, Web of S cience using the key words “hepatocellular carcinoma”, “chronic hepatitis C”, “direct-acting antiviral drugs”, “liver cirrhosis”, “interferons”, and “sustained virological response”. Of the 99 studies found, 21 were used to write a systematic review.Results. Eradication of the virus reduces the risks of HCC. Despite reports on high risk of occurrence or recurrence of hepatocellular carcinoma in patients with cirrhosis after treatment with DAA s compared with interferon-containing regimens, there is not enough data confirming the direct link between the use of DAA s and the development of hepatocellular carcinoma. No statistically significant difference in the frequency of HCC between patients treated with interferon or DAA s was detected.Conclusion. Eradication of the virus is the most significant factor in the prevention of HCC; therefore, treatment of CHC should not be delayed due to the risk of HCC. Patients with liver cirrhosis require a long period of follow-up, even after successful treatment of chronic hepatitis C with DAA drugs. Stratification of HCC risk requires further research.

scholarly journals The impact of achieving a sustained virological response with direct-acting antivirals on serum autotaxin levels in chronic hepatitis C patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shereen Abou Bakr Saleh ◽  
Khaled Mohamed Abdelwahab ◽  
Asmaa Mady Mady ◽  
Ghada Abdelrahman Mohamed
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Hepatic Fibrosis ◽  
Virological Response ◽  
Direct Acting Antivirals ◽  
Fibrosis Regression ◽  
Direct Acting ◽  
The Impact

Abstract Background Autotaxin (ATX) is an emerging biomarker for liver fibrosis. Achievement of sustained virological response (SVR) by direct-acting antivirals (DAAs) results in hepatic fibrosis regression in chronic hepatitis C (CHC) patients. In this context, the clinical implications of ATX have not yet been well-defined. In this study, we aimed to assess the impact of achieving SVR with DAA therapy on serum ATX levels and whether these levels can reflect the regression of hepatic fibrosis in CHC patients. We evaluated serum ATX levels at baseline and 12 weeks post-DAA therapy in 48 CHC patients. We compared ATX with FIB4 score and AST-to-Platelet Ratio Index (APRI) as regards the detection of grade F3–4 fibrosis. Results Serum ATX levels were significantly declined in 47 patients after the achievement of SVR12 (p < 0.001). The diagnostic ability of ATX for the detection of grade F3–4 fibrosis was inferior to FIB4 and APRI scores at baseline and SVR12. Conclusion Achievement of SVR with DAA therapy causes a significant decline in serum autotaxin concentrations, suggesting early regression of hepatic fibrosis in CHC patients. However, its diagnostic capability for routine patient monitoring and follow-up is still under debate.

scholarly journals Evaluation of Non-invasive Scores Before and After Direct-acting Antiviral Treatment in Patients with Chronic Hepatitis C

ANKEM Dergisi ◽  
2020 ◽  
Author(s):  
Aziz Ahmad Hamidi ◽  
Cüneyt Kuru
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Direct Acting Antiviral ◽  
Non Invasive ◽  
Before And After ◽  
Direct Acting

The sustained virological response is achieved in patients with chronic hepatitis C infection using direct-acting antiviral (DAA) therapy. However, it is not known whether there is a decrease in liver fibrosis level. Non-invasive serum scores are successful in determining the level of liver fibrosis before treatment. There are no adequate studies in the literature about the use of these scores after treatment. This study aimed to determine the change in inflammation and fibrosis levels after treatment by using non-invasive scores. Adult patients who applied to the Karabuk University Training and Research Hospital between January 2019 and January 2020 and used DAA treatment were included in the study. Clinical and laboratory findings of the cases were recorded retrospectively from the hospital information system. Fibrosis-4 (FIB-4), aspartate aminotransferase (AST)-platelet ratio index (APRI), γ glutamate transpeptidase-platelet ratio (GPR) and AST / ALT ratio scores were calculated before and after (24th week) treatment. Forty-two patients with a mean age of 56.4 were evaluated. 52% of these patients were women. All patients developed a sustained virological response. Genotype 1b was the most common (67 %). The most commonly used treatment regimen (60 %) was paritaprevir + ritonavir + ombitasvir + dasabuvir. After treatment compared to pretreatment, mean AST value decreased from 24.69 to 20.67, mean ALT value decreased from 20.57 to 15.31 and APRI from 0.33 to 0.29 (p=0.01; p=0.03; p=0.01, respectively). Although not statistically significant, FIB-4 was low after treatment. In conclusion, the use of non-invasive serum biomarker scores may be useful in the follow-up of chronic hepatitis C cases using DAA treatment.

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