scholarly journals 1069. Loss to follow-up does not impact SVR for HCV infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S563-S563
Author(s):  
Sita K Kottilil ◽  
Mrunal Kamat ◽  
Amit Gupte ◽  
Samir Shah
Keyword(s):  
Hepatitis C ◽  
Previous Treatment ◽  
Virologic Response ◽  
Post Treatment ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Duration Of Treatment ◽  
Group A ◽  
Group B

Abstract Background Recent advances in hepatitis C treatment using direct acting antiviral (DAA) agents can lead to sustained virologic response (SVR) in almost all treated subjects. These data along with the availability of generic DAAs have generated optimism to eliminate HCV infection globally. However, recent pilot projects aimed at HCV elimination have resulted in disappointing SVR due to lack of follow up of patients after they complete treatment. In this study, we evaluated the SVR among those who did not follow up for the 12 week post treatment visit versus that of those who did, Aim – To determine SVR among those who follow up compared to those who have delayed follow up to assess SVR. Table Methods 226 patients who underwent treatment for hepatitis C in a subspecialty clinic in Mumbai, India between 2014-16, with complete laboratory and clinical data available were included in this analysis. All patients completed 12 weeks of treatment with an approved DAA regimen. 137 patients had adequate follow up post treatment for SVR (Group A) and 89 patients were “no shows” for SVR (Group B) and had to be actively followed to obtain HCV RNA levels at least 4 weeks after SVR visit. Graph Pad prizm and student t test were used to determine the difference between SVR among the two groups. Results Demographics of both groups of patients are shown in the table below. SVR for the patients with good follow up (Group A) was 97.1% (133/137) and that of patients with poor follow up (Group B) was 97.8% (87/89), which was not statistically different (p >0.05). There were no baseline demographics that was associated with poor follow up, including age, gender, genotype, baseline fibrosis score, ALT levels, previous treatment status, or duration of treatment (P >0.05) Conclusion Lack of follow up after completion of treatment with DAAs is associated with identical SVR compared to those with adequate follow up. These findings suggest lack of follow up after completion of treatment should have minimal effect on HCV elimination projects. In the future, HCV elimination projects need not focus on determination of SVR as long as treatment follow up is ensured Disclosures All Authors: No reported disclosures

Serologic, Virologic, and Histologic Characteristics of Chronic Phase Hepatitis C Virus Disease in Children Infected by Transfusion

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 919-922
Author(s):  
Suguru Matsuoka ◽  
Katsuyoshi Tatara ◽  
Yasunobu Hayabuchi ◽  
Yoshiyuki Taguchi ◽  
Kazuhiro Mori ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Acute Infection ◽  
Chronic Phase ◽  
Hcv Infection ◽  
Core Antigen ◽  
Hcv Rna ◽  
Histologic Evidence ◽  
Group A ◽  
Group B

Objective. We studied the time course of hepatic dysfunction, seropositivity to hepatitis C virus (HCV) antibodies, viremia, and histologic evidence of hepatic injury to evaluate the course of HCV infection in children infected by blood transfusion. Patients and methods. Twenty-nine patients (ages 4 to 18 years) who underwent open-heart surgeries for congenital heart disease were grouped into three categories based on alterations in serum alanine aminotransferase (ALT) levels: Group A, acute infection; Group B, subacute infection; and Group C, chronic infection. Results. In Group C, all 13 patients had detectable HCV RNA in serum. In contrast, all patients in Group A had no detectable HCV RNA. In Group B, one of nine patients had detectable HCV RNA and two of four patients examined had persistent chronic hepatitis by histologic criteria. Antibodies directed against C100-3 antigen or core-antigen were more useful than second-generation HCV antibody assays in determining the relationship between viremia and immunologic response. Infection with HCV genotype II and the presence of higher HCV RNA copy numbers were associated with histologic evidence of hepatic damage. Conclusion. An abnormal ALT value is frequently associated with viremia, and biochemically resolved acute infection reflects clearance of HCV. However, a normal ALT does not always reflect an absence of hepatocyte damage and HCV replication in patients with subacute disease. The measures outlined in this study are useful indicators of disease activity during the chronic phase of post-transfusion HCV infection.

scholarly journals Therapy of chronic hepatitis C: Virologic response monitoring

2010 ◽  
Vol 67 (11) ◽  
pp. 923-927 ◽  
Author(s):  
Nada Kuljic-Kapulica ◽  
Dragutin Jovanovic ◽  
Dejana Savic ◽  
Elizabeta Ristanovic ◽  
Darko Nozic ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Post Treatment ◽  
Hcv Infection ◽  
Response Monitoring ◽  
Hcv Rna ◽  
Genotype 4

Background/Aim. Virological testing is considered to be essential in the management of hepatitis C virus (HCV) infection in order to diagnose infection, and, most importantly, as a quide for treatment decisions and assess the virological response to antiviral therapy. The aim of this study was to determine the rate of a sustained virological response (SVR) and various factors associated with response rates in chronic hepatitis C infected patients treated with pegiinterferon alpha (PEGINF) and ribavirin (RBV) combination therapy. Methods. A total of 34 patients, treated with PEG-IFN and RBV were studied. Serum HCV-RNA was measured before the treatment, 12 weeks following the start of the therapy and 6 weeks after the treatment cessation. SVR was defined as undetectable serum HCV-RNA 6 months of post-treatment follow-up, virologic relapse (VR) as relapse of HCV-RNA during the post-treatment follow-up. Serum HCV-RNA was measured with the Cobas Amplicor test. Results. At the end of post-treatment follow-up 19 (55.8%) patients demonstrated a SVR. The majority of the patients were genotype 1 (27), and the other were genotype 3 (5 patients) and genotype 4 (2 patients). There was VR in 6 patients 6 months after the therapy. In 9 patients HCV-RNA was positive after 12 weeks. Conclusion. We demonstrated that patients with chronic HCV infection can be successfully treated with combination of PEG-INF and RBV. This result emphasizes also that post-treatment follow-up to identify patients with SVR or VR could be important.

P1652IMPACT OF HEPATITIS C VIRUS AND DIRECT ACTING ANTIVIRALS ON JAPANESE RENAL ALLOGRAFT RECIPIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Kazuaki Okino ◽  
Keita Yamazaki ◽  
Keiichiro Okada ◽  
Keiji Fujimoto ◽  
HIROKI ADACHI ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Renal Allograft ◽  
Patient Survival ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Direct Acting Antivirals ◽  
Group A ◽  
Group B ◽  
Direct Acting ◽  
The Impact

Abstract Background and Aims The impact of hepatitis C virus (HCV) infection on patient survival after renal transplantation was worse. Previously, we found that continuous HCV infection was a significant independent risk factor for actuarial survival (especially at ≥20 years after the transplant procedure) among Japanese renal allograft recipients. This study evaluates the impact of HCV and of the new direct acting antivirals (DAAs) on patient outcomes in renal allograft recipients. Method We studied 46 cases (28 males, 18 females; 37 living-donor cases, 9 deceased-donor cases; mean follow-up period 305 months ranging from 2 to 420 months) out of the 315 renal transplanted patients who underwent the first renal transplantation in Kanazawa Medical University since 1974. They had antibodies against HCV: 11 were positive for HCV RNA and received DAAs (Group A, all of them genotype 1b); 27 were HCV RNA positive and did not receive any treatment (Group B); 8 were negative for HCV RNA (Group C) (Fig.1). Results All Group A patients had HCV RNA negativity after 2-12 weeks of treatment started, and 11 (100%) achieved a sustained virological response (SVR) at 24 weeks. All of them had no adverse effects by the use of DAAs. In this cohort, no patients in Group A died. On the other hand, 15 (55.5％) of 27 in Group B and 3 (37.5%) of 8 in Group C died. Causes of death among Group B were liver cirrhosis (5 cases), hepatocellular carcinoma (2 case), infections complicated with chronic hepatitis (6 cases) in chronic phase, fibrosing cholestatic hepatitis due to HCV (1 case) after surgery, and cardiovascular disease (1 case). The patient survival rate was significantly higher in Group A patients who received DAAs by Kaplan- Meier life table method (Log Rank test, Kay-square 11.7, p=0.004) (Fig.2). Conclusion Our results support the notion that continuous HCV infection was a harmful and that new DAAs were efficient and safe to treat HCV infection after renal transplantation.

The Efficacy of Herbal Medicine (Kampo) in Reducing the Adverse Effects of IFN-β in Chronic Hepatitis C

2002 ◽  
Vol 30 (02n03) ◽  
pp. 355-367 ◽  
Author(s):  
Mosaburo Kainuma ◽  
Jun Hayashi ◽  
Shinya Sakai ◽  
Kazuaki Imai ◽  
Naoki Mantani ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Adverse Effects ◽  
Chronic Hepatitis C ◽  
Hcv Rna ◽  
Antiviral Effects ◽  
Group A ◽  
Laboratory Examinations ◽  
Ifn Treatment ◽  
Group B

The purpose of this study was to determine if the adverse effects of interferon (IFN) in hepatitis C patients could be reduced by treatment with Japanese Oriental (Kampo) medicine. Twelve patients with chronic hepatitis C were treated with a combination of IFN-β and either Mao-to or Dai-seiryu-to (groups A and B), and 16 patients were treated with IFN-β alone (group C). Mao-to was administered to eight patients and Dai-seiryu-to was administered to four in groups A and B, respectively. Adverse effects were evaluated by clinical and laboratory examinations. The severity of symptoms was daily self-classified into four categories (1: none, 2: very slight, 3: moderate, and 4: serious), using a questionnaire consisting of 29 items. Scores of symptom such as discomfort and fever in group A, and discomfort, general malaise, paresthesia and arthralgia in group B were significantly lower than those in group C (p > 0.05). In all patients, HCV-RNA was negative at the end of the treatment, and serum alanine aminotransferase (ALT) levels had normalized transiently in all group A and B patients with genotype 1b by 2 weeks after cessation of IFN treatment. This study indicates that Kampo medicines are useful for reducing the adverse effects accompanying IFN treatment in patients with chronic hepatitis C without reducing the antiviral effects.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005 ◽  
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

Abstract When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

scholarly journals Evidence of hepatitis in patients receiving transfusions of blood components containing antibody to hepatitis C

Blood ◽  
1993 ◽  
Vol 82 (3) ◽  
pp. 1000-1005
Author(s):  
SK Aoki ◽  
PV Holland ◽  
LP Fernando ◽  
IK Kuramoto ◽  
S Anderson ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Components ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Immunoblot Assay ◽  
Polymerase Chain ◽  
Hepatitis C Virus Antibody

When hepatitis C virus antibody (anti-HCV) enzyme immunoassay (EIA1) testing became available in 1990, we tested samples from previously transfused blood units, traced the recipients of reactive units, and evaluated the recipients for HCV infection during the 12 months after transfusion. Ten of 42 recipients of EIA1-reactive blood were anti-HCV reactive on follow-up by EIA1 and 12 were reactive by a second- generation assay (EIA2). Reverse transcriptase-polymerase chain reaction (RT-PCR) detected HCV RNA in 5 seronegative recipients. In all, 17 of 42 recipients (40%) of EIA1-reactive blood had evidence of HCV infection. In comparison, 54 surgery patients, who received either no transfusion or autologous EIA1-nonreactive blood, remained EIA1 nonreactive and RT-PCR negative for 1 year; 1 patient (1.8%) became EIA2 reactive (P < or = .01). Of the recipients of anti-HVC reactive blood transfusions (reactive by both EIA1 and a supplemental 4-antigen strip immunoblot assay [RIBA2]), 14 (93%) of the recipients had evidence of HCV infection compared with only 3 of 27 recipients (11%) of EIA1-reactive, RIBA2-nonreactive blood (P < or = .01). Thus, blood components reactive for anti-HCV EIA1 may have transmitted HCV up to 40% of the time, but blood components found reactive by both EIA1 and RIBA2 may transmit HCV with a frequency of greater than 90%.

scholarly journals COMBINED NS5A & NS5B NUCLEOTIDE INHIBITOR THERAPY FOR PATIENTS WITH CHRONIC HEPATITIS C WITH STAGE 5 CHRONIC KIDNEY DISEASE ON HEMODIALYSIS

2020 ◽  
Vol 57 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Prasanta DEBNATH ◽  
Sanjay CHANDNANI ◽  
Pravin RATHI ◽  
Sujit NAIR ◽  
Vinay PAWAR ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Post Treatment ◽  
Hcv Infection ◽  
Maintenance Hemodialysis ◽  
Hcv Rna ◽  
Genotype 3 ◽  
Open Label ◽  
Genotype 2

ABSTRACT BACKGROUND: Hepatitis C virus (HCV) infection is the most common hepatotropic viral infection affecting the patients on maintenance hemodialysis. Treatment of chronic HCV infection in stage 4 and 5 CKD includes a combination of elbasvir/grazoprevir and glecaprevir/pibrentasvir, which are not available in many countries. OBJECTIVE: Hence, we have conducted this study to look for the safety and efficacy of sofosbuvir combination therapy in this difficult to treat population. METHODS: We conducted a single-center, prospective, open-label study in which Stage 5 CKD patients on maintenance hemodialysis with HCV infection. Total of 18 patients was included. sofosbuvir with daclatasvir or ledipasvir was used according to genotype for 12 weeks. HCV RNA, genotype, transient elastography (TE) was considered for every patient. HCV RNA was quantified at 4th week, 12th week and 12 weeks post-treatment to look for sustained virologic response (SVR 12). RESULTS: Infection due to genotype 1 was seen in 12 (66.7%) patients followed by genotype 3 in 4 (22.3%) with each patient of genotype 2 and 5. The median value of HCV RNA was 2,35,000 IU/mL. On TE, all had liver stiffness of <9.4 KPa. All patients had HCV RNA of <15 IU/mL at 4th and 12th week of treatment and 12 weeks post-treatment. No significant change in hemoglobin, eGFR and liver stiffness was observed. CONCLUSION: Full dose sofosbuvir i.e. 400 mg, in combination with NS5A inhibitors daclatasvir or ledipasvir is found to be safe and effective in patients with end stage renal disease, who are on maintenance hemodialysis.

scholarly journals HEPATITIS-C GENOTYPE-3A INFECTION;

2017 ◽  
Vol 24 (05) ◽  
pp. 670-674
Author(s):  
Nizamuddin - ◽  
Abdul Hameed Khan ◽  
Ayesha Jamil ◽  
Fazal Rahim ◽  
Muhammad Riaz
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Human Factor ◽  
Dual Therapy ◽  
P Value ◽  
Hcv Rna ◽  
Group A ◽  
Group B ◽  
Genotype 3A

Objectives: In last decade, “treatment of chronic hepatitis-C revolved frominterferon based therapy to most effective interferon free therapy with new direct antiviraldrugs like Sofosbuvir and ribavirin” which is recommended for all genotypes of HCV infection.Treatment response in Chronic Hepatitis-C is affected both by viral and human factors. Weconducted this study “to evaluate the effect of human factor like (IL28B-rs12979860 non-CC)genotyping in response to Sofosbuvir based dual therapy in Hepatitis-C Genotype-3a infection”in population of Khyber PukhtoonKhwa (KPK). Setting: This open labeled, multi-center studywas conducted in Peshawar-Khyber PukhtoonKhwa (KPK). Period: March-2016 to August-2016.Method: Total of 70patients were enrolled. After doing “PCR for HCV-RNA-Viral level, Viral-Genotyping and Human genotyping for IL-28B, patients were put on Sofosbuvir and ribavirin for24-weeks”. Patients were assigned into two groups (1:1), “having 35 in each, including group-Aas those having favorable CC (IL28B- rs12979860-CC) genotyping and group-B as thosehaving unfavorable non-CC (IL28B-rs12979860-non-CC) genotyping”. The primary end pointwas “Sustained Virological response12 (SVR12), which is HCV-RNA level<40IU/ml at 12-weeksafter completion of therapy in these two groups”. Results: Among 70-patients, male-femaleratio was 57.15% (n=40) and 42.85% (n=30) respectively. Each group has 35-cases. Rate ofSVR12 was 88.57% (n=31/35) in group-A, 91.42% (n=32/35) in group-B, having P-value<05.Conclusion: This study confirm that “unlike interferon, unfavorable non-CC (IL28B-rs12979860-non-CC) genotyping have no or minimal role in treatment response to Sofosbuvir in Hepatitis-Cgenotype-3a infections”.

scholarly journals Efficacy and Safety of Ombitasvir/Paritaprevir/Ritonavir ± Dasabuvir Regimen in Haemodialysis Patients With Hepatitis C Virus Infection

2020 ◽  
Vol 39 (1) ◽  
pp. 23-27
Author(s):  
Antonija Verhaz ◽  
Tatjana Roganović ◽  
Ljiljana Pašić ◽  
Olja Čuković ◽  
Tanja Macanović-Kostić
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Adverse Events ◽  
Concomitant Medication ◽  
Demographic Data ◽  
Virologic Response ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Stage Renal Disease

Background: Hepatitis C virus (HCV) infection is common among patients on haemodialysis (HD) therapy and is an important cause of morbidity and mortality. In patients with chronic kidney disease (CKD), the risks for negative outcomes are significantly higher in HCV-infected patients than in those without HCV infection, including progression to cirrhosis, hepatocellular carcinoma and liver-related mortality. Ombitasvir (OBV), paritaprevir (PTV), ritonavir (r), and dasabuvir (DSV) are all hepatically metabolized and, therefore, require no dose adjustment in patients with any degree of renal impairment. Aims: We studied the safety and efficacy of OBV/PTV/r + DSV in a small group of HCV infected patients on haemodialysis therapy. Methods: Treatment course with ombitasvir/paritaprevir/ritonavir and dasabuvir; (3-DAA regimen of OBV/PTV/r+DSV±RBV) was analysed. Pre-treatment evaluation of HCV infection included HCV RNA, genotype, and liver fibrosis assed by transient fibroelastography (FibroScan). The stage 5 CKD was defined as an eGFR of &lt;15 mL/min/1.73 m2, respectively; those on haemodialysis were considered to have stage 5 CKD or end-stage renal disease (ESRD). Demographic data and concomitant medication were retrieved from patients’ records. The primary endpoint was sustained virologic response at post-treatment week 12 (SVR12). We collected data on on-treatment adverse events (AEs), serious AEs, and laboratory abnormalities. Results: Among 7 treated patients, 6 were male and 1 female, all were infected with genotype 1 (5 GT1b, 2 GT1a). Patient had compensated liver cirrhosis and six patients did not have liver cirrhosis, none were liver transplant recipients. All of seven patients completed 12 weeks of treatment and achieved SVR12. Concomitant medication had to be modified with the treatment initiation in 5 out of 7 patients. One of the patients presented with a significant decrease in haemoglobin level, white blood cell and platelet count during the treatment period. The most frequent adverse events were nausea, diarrhoea. Adverse events were primarily mild, and no patient discontinued treatment due to an AE. Conclusions: Treatment with OBV/PTV/r +DSV ± RBV was well-tolerated and resulted in high rates of SVR12 (100%) for patients with HCV GT1b/1a on haemodialysis.

A Comparison of Acupuncture with Advice and Exercises on the Symptomatic Treatment of Osteoarthritis of the Hip – a Randomised Controlled Trial

2001 ◽  
Vol 19 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Roisin Haslam
Keyword(s):  
Controlled Trial ◽  
Randomised Trial ◽  
Symptomatic Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Randomised Controlled

Acupuncture is becoming a common technique within the physiotherapy profession as a treatment modality for pain relief; however, few randomised controlled trials have been undertaken to assess the effectiveness of acupuncture, particularly in the treatment of osteoarthritis (OA) of the hip. Therefore, a randomised trial to compare the effectiveness of acupuncture with advice and exercises on the symptomatic treatment of OA of the hip was carried out. Thirty-two patients awaiting a total hip arthroplasty were randomly allocated to either the experimental group, (A), to have six sessions of acupuncture each lasting up to 25 minutes, or the control group, (B), to be given advice and exercises for their hip over a six week period. Group A consisted of three men and 13 women, and group B consisted of four men and eight women. The average age in group A was 66 years and in group B it was 68 years. Patients were assessed for pain and functional ability, using a modified version of the WOMAC questionnaire, pre-treatment, immediately post-treatment and at eight weeks post-treatment. The pre-treatment WOMAC scores in the two groups were similar (p=0.85). There was a significant improvement in group A (decrease in WOMAC score) immediately post-treatment (p=0.002) and this was maintained at the eight-week follow-up (p=0.03). There were no significant changes in group B. When the changes in WOMAC scores were compared between groups, a significantly greater improvement was found between pre-treatment and immediately post-treatment in group A, compared with group B (p=0.02). The changes between pre-treatment and the eight-week follow-up also showed a significant improvement in group A compared with group B (p=0.03). In conclusion, this trial supports the hypothesis that acupuncture is more effective than advice and exercises in the symptomatic treatment of OA of the hip.

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