Postsustained Virological Response Management in Hepatitis C Patients

AbstractThe introduction of direct-acting antiviral agents (DAA) has revolutionized management and care of patients with chronic hepatitis C virus (HCV) infection, leading to cure rates higher than 90% in patients with advanced liver disease as well. Viral eradication has been associated with longer survival, reduced mortality from both hepatic and extrahepatic causes, improvement in liver function, and reduced incidence of HCV-related extrahepatic diseases. While patients with mild fibrosis can safely be discharged after achievement of a sustained virological response, patients with advanced fibrosis and cirrhosis remain at risk of developing complications of liver disease, thus requiring regular and life-long surveillance. Major complications of cirrhosis that need to be monitored are hepatocellular carcinoma onset and development or progression of clinically significant portal hypertension.

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Virological Factors Associated with Failure to the Latest Generation of Direct Acting Agents (DAA) and Re-Treatment Strategy: A Narrative Review

Viruses ◽

10.3390/v13030432 ◽

2021 ◽

Vol 13 (3) ◽

pp. 432

Author(s):

Lorenzo Onorato ◽

Mariantonietta Pisaturo ◽

Mario Starace ◽

Carmine Minichini ◽

Alessandra Di Fraia ◽

...

Keyword(s):

Liver Disease ◽

Hepatitis C ◽

Antiviral Agents ◽

Clinical Problem ◽

Narrative Review ◽

Factors Associated ◽

Direct Acting Antiviral ◽

Direct Acting ◽

The Impact ◽

Direct Acting Antiviral Agents

The availability of all oral direct acting antiviral agents (DAAs) has revolutionized the management of HCV infections in recent years, allowing to achieve a sustained virological response (SVR) in more than 95% of cases, irrespective of hepatitis C Virus (HCV) genotype or staging of liver disease. Although rare, the failure to the latest-generation regimens (grazoprevir/elbasvir, sofosbuvir/velpatasvir, pibrentasvir/glecaprevir) represents a serious clinical problem, since the data available in the literature on the virological characteristics and management of these patients are few. The aim of the present narrative review was to provide an overview of the impact of baseline RASs in patients treated with the latest-generation DAAs and to analyze the efficacy of the available retreatment strategies in those who have failed these regimens.

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Low Adherence Achieves High HCV Cure Rates Among People Who Inject Drugs Treated With Direct-Acting Antiviral Agents

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa377 ◽

2020 ◽

Vol 7 (10) ◽

Cited By ~ 1

Author(s):

Brianna L Norton ◽

Matthew J Akiyama ◽

Linda Agyemang ◽

Moonseong Heo ◽

Irene- Pericot-Valverde ◽

...

Keyword(s):

Hepatitis C ◽

People Who Inject Drugs ◽

Antiviral Agents ◽

Virologic Response ◽

Direct Acting Antiviral ◽

Suboptimal Adherence ◽

Direct Acting ◽

Cure Rates ◽

Methadone Program ◽

Direct Acting Antiviral Agents

Abstract We measured hepatitis C virus (HCV) adherence via electronic blister packs for 145 people who inject drugs treated on-site in a methadone program. The overall sustained virologic response (SVR) rate was 96% (95% CI, 91%–98%), and overall daily adherence was 78% (95% CI, 76%–81%). Participants who achieved at least 50% adherence had an overall SVR rate of 99%, with each 5% adherence interval >50% achieving at least 90% adherence. Suboptimal adherence may still lead to cure in the direct-acting antiviral era.

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Histological assessment of the liver explant in transplanted hepatitis C virus patients achieving sustained virological response with direct-acting antiviral agents

Histopathology ◽

10.1111/his.13453 ◽

2018 ◽

Vol 72 (6) ◽

pp. 990-996 ◽

Cited By ~ 5

Author(s):

Juan Putra ◽

Thomas D Schiano ◽

M Isabel Fiel

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Sustained Virological Response ◽

Virological Response ◽

Antiviral Agents ◽

Histological Assessment ◽

Direct Acting Antiviral ◽

Direct Acting ◽

Direct Acting Antiviral Agents

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Treatment of chronic hepatitis C with direct acting antiviral agents in patients with haemophilia, end-stage liver disease and coinfected with HIV

Haemophilia ◽

10.1111/hae.12899 ◽

2016 ◽

Vol 22 (3) ◽

pp. e223-e225

Author(s):

R. Ackens ◽

D. Posthouwer

Keyword(s):

Chronic Hepatitis ◽

Liver Disease ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Antiviral Agents ◽

Direct Acting Antiviral ◽

End Stage Liver Disease ◽

Direct Acting ◽

End Stage ◽

Direct Acting Antiviral Agents

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Efficacy and Safety of Sofosbuvir-Based Direct-Acting Antiviral Agents Treatment for Patients with Genotype 3/6 Hepatitis C Virus Infection

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2020/8872120 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Yong-yu Mei ◽

You-ming Chen ◽

Yuan-kai Wu ◽

Xiao-hong Zhang ◽

Wen-xiong Xu

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Virological Response ◽

Antiviral Agents ◽

Hcv Infection ◽

Efficacy And Safety ◽

Direct Acting Antiviral ◽

Direct Acting ◽

Direct Acting Antiviral Agents

Aims. The aim is to evaluate the efficacy and safety of Sofosbuvir- (SOF-) based direct-acting antiviral agents (DAAs) treatment for patients with genotype (GT) 3/6 hepatitis C virus (HCV) infection. Methods. Patients infected with GT 3/6 HCV and treated with SOF-based DAAs were enrolled in this prospective, open, single-center, and real-world study. Drugs included Sofosbuvir (SOF), Velpatasvir (VEL), Daclatasvir (DCV), and Ribavirin (RBV). The treatment regimens included SOF + RBV for 24 weeks, SOF + DCV ± RBV for 12/24 weeks, and SOF/VEL ± RBV for 12 weeks. Results. A total of 54 patients were included. Age was 42.5 ± 10.4 years. Baseline HCV RNA was 6.29 ± 0.89log10 IU/mL. The numbers of GT 3a, 3b, and 6a patients were 10, 12, and 32, respectively. The numbers of chronic hepatitis, compensated cirrhosis, and decompensated cirrhosis patients were 39, 9, and 6, respectively. In patients with chronic hepatitis C and liver cirrhosis, sustained virological response 12 weeks after the end of treatment (SVR12) was 97.4% and 96.7%, respectively, and rapid virological response (RVR) was 75.0% and 57.1%, respectively. SVR12 of GT3a, GT3b, and GT6a was 100%, 83.3%, and 97%, respectively. ALT normality rate in chronic hepatitis group is higher than that in cirrhosis group at 4 weeks of treatment (89.7% versus 60.0%, p = 0.033) and at 12 weeks after EOT (94.9% versus 66.7%, p = 0.021). The overall incidence rate of adverse events was 44.4%, with fatigue being the most common (13.0%). Conclusion. SOF-based DAAs regimen can achieve ideal SVR12 for Chinese patients with both GT3a and GT6a HCV infection. The tolerance and safety of SOF-based DAAs regimen are good.

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