The treatment of HCV in patients with haemoglobinopathy in Kurdistan Region, Iraq: a single centre experience

SUMMARYVarious variables that might influence the rapid and sustained virological response to recombinant PEG-IFN-α-2a were explored in Iraqi HCV-infected patients with haemoglobinopathy. Forty-three patients were evaluated for the relationship between rapid virological response (RVR), IL-28B polymorphism, viral load, liver enzyme levels, blood group, ultrasound findings, or HCV genotype and the sustained virological response (SVR) achievement. The overall RVR was 55·81% while the overall SVR was 53·49%. SVR in patients that achieved RVR was 82·61% (P = 0·0004). A significant association was found between initial alanine transaminase levels and viral load with SVR achievement (P = 0·025) and (P = 0·004), respectively. Thirty-two (74%) out of 43 of our samples were host genotyped at the IL-28B locus as CC, a significant association was found between CC group and SVR achievement (P = 0·04). Of our samples, 23/43 (53%) were typed as HCV genotype 4, 10/43 (23%) as genotype 1, 9/43 (20·9%) as genotype 3 and 1/43 (2·3%) as genotype 2. A significant association was found between genotype 3 and SVR achievement (P = 0·006). Multivariate analysis showed that only RVR achievement independently associated with SVR in the Iraqi population (P = 0·00). These results can be used to classify the patients requiring the more expensive new direct-acting antiviral drugs.

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VIROLOGICAL RESPONSES OF VELPATASVIR/SOFOSBUVIR IN PATIENTS WITH HCV GENOTYPE 3

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i1.397 ◽

2020 ◽

Vol 11 (1) ◽

pp. 9-14

Author(s):

Muhammad Sarfraz ◽

Arshad Rabbani ◽

Muhammad Shahzad Manzoor ◽

Benish Adil

Keyword(s):

Treatment Response ◽

Sustained Virological Response ◽

Virological Response ◽

Hcv Rna ◽

Rapid Virological Response ◽

Genotype 3 ◽

Hcv Genotype ◽

End Of Treatment ◽

Treatment Naïve ◽

Hcv Genotype 3

BACKGROUND & OBJECTIVE: The role of Velpatasvir/Sofosbuvir in the treatment of hepatitis C virus type 3 infection is evaluated in terms of virologic responses. i.e Rapid Virological Response (RVR) End of treatment response (ETR) and Sustained virological response (SVR 12). METHODOLOGY: This was a descriptive case study conducted in Liver OPD of Benazir Bhutto Hospital during 01 November 2018 to 30 April 2019 , in which 100 patients of HCV were enrolled, all of them had HCV genotype 3 infection. Every patient was treated with combination of Velpatasvir/Sofosbuvir 100mg/400 mg Once Daily as part of treatment regimen of HCV infection for 12 weeks. Pre-treatment HCV RNA QUANTITATIVE PCR was done, which was repeated on 4, 12 weeks of treatment and then 12 weeks post treatment. RESULTS: Among 100 patients, 51 (51%) were male and 49 (49%) were females. Mean age of patients was 43.2 ± 10.4 years (mean ± SD). Mean BMI of enrolled patients was 21.34 ± 2.40 kg/m2. 33% patients were cirrhotic while 67% were non cirrhotic. 53% patients were treatment experienced while 47% were treatment naïve. Rapid Virological Response (RVR) was achieved in 92%, End of treatment response (ETR) was achieved in 96%, while Sustained Virological response (SVR12) was achieved in 99% patients. The results were stratiﬁed according to age, gender and BMI. There was no eﬀect of these parameters on the ﬁnal results. CONCLUSION: Virological response (RVR, ETR, SVR12) of Velpatsvir /Sofosbuvir and Ribavirin is encouraging.

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Direct-acting antiviral treatment for hepatitis C genotypes uncommon in high-income countries: a Dutch nationwide cohort study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab006 ◽

2021 ◽

Author(s):

Cas J Isfordink ◽

Thijs J W van de Laar ◽

Sjoerd P H Rebers ◽

Els Wessels ◽

Richard Molenkamp ◽

...

Keyword(s):

The Netherlands ◽

Antiviral Treatment ◽

High Income ◽

Genotype 3 ◽

Middle Income ◽

Hcv Genotype ◽

Direct Acting Antiviral ◽

Middle Income Countries ◽

Genotype 2 ◽

Direct Acting

Abstract Background The majority of HCV infections are found in low- and middle-income countries, harboring many region-specific HCV subtypes. Nevertheless, direct-acting antivirals (DAA) trials were almost exclusively conducted in high-income countries, where mainly epidemically spread HCV subtypes are present. Recently, several studies demonstrated sub-optimal DAA efficacy for certain non-epidemic subtypes, which could hamper global HCV elimination. Therefore, we aimed to evaluate DAA efficacy in patients treated for a non-epidemic HCV genotype infection in the Netherlands. Methods We performed a nationwide retrospective study including patients treated with interferon-free DAA for a HCV genotype other than 1a/1b/2a/2b/3a/4a/4d. Genotype was determined by NS5B-region phylogenetic analysis. Primary endpoint was SVR-12. If stored samples were available, NS5A and NS5B sequences were obtained for resistance-associated substitutions (RAS) evaluation. Results We included 160 patients, mainly infected with non-epidemic genotype 2 (41%) and 4 (31%) subtypes. Most patients originated in Africa (45%) or South America (24%); 51 (32%) were cirrhotic. SVR-12 was achieved in 92% (140/152) of patients with available SVR-12 data. Only 73% (8/11) genotype 3 infected patients achieved SVR-12, the majority being genotype 3b patients with 63% (5/8) SVR. Regardless of SVR, all genotype 3b patients had 30K and 31M RAS. Conclusions DAA efficacy in most non-epidemic genotypes in the Netherlands seems reassuring. However, the low SVR-12 rate in subtype 3b infections is alarming, especially as it is common in several HCV endemic countries. Alongside earlier results, our results indicate that a remaining challenge for global HCV elimination is confirming and monitoring DAA efficacy in non-epidemic genotypes.

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