Ledipasvir/Sofosbuvir Is Safe and Effective for the Treatment of Patients With Genotype 1 Chronic HCV Infection in Both HCV Mono-and HCV/HIV Co-Infected Patients

Background/Aim. Hepatitis C is an important sociomedical problem worldwide due to frequent progression to chronic disease, occurrence of liver cirrhosis and hepatocellular carcinoma. Standard pegylated interferon alfa 2a plus ribavirin therapy results in resolution of infection only in 50% of patients. The aim of this study was to determine the association of various factors with response to the therapy in patients with chronic hepatitis C virus (HCV) infection. Age and sex of patients, inoculation risk factors, histopathological changes in the liver, viral load and HCV genotype were analyzed. Methods. The study included a group of 121 patients with chronic HCV infection. The treatment was carried out 24 weeks for virus genotype 2 and 3, and 48 weeks for genotype 1 and 4. The degree of histopathological changes in the liver was determined by hematoxylin and eosin staining, whereas polimerase chain reaction was used for HCV genotyping. Results. In the group of non-responding patients genotype 1 was represented with 100%, while in the other groups, although predominantly present, its percentage was lower. Unresponsiveness to therapy and relapse of disease were associated with higher viral load and advanced fibrosis. Intravenous use of psychoactive substances, as a risk factor, was present in a high percentage in the group of patients with sustained response, while blood transfusion and dialysis were leading risk factors in the group of relapse responders and non-responders. Conclusion. The results of our study showed that the treatment outcome of chronic HCV infection was associated with baseline HCV ribonucleic acid, HCV genotype, route of infection and the degree of histopathological changes in the liver.

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Effectiveness of directly acting oral antivirals in treatment of chronic HCV infection in children - experience from a tertiary care institute in southern India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20210262 ◽

2021 ◽

Vol 8 (2) ◽

pp. 191

Author(s):

Senthil Kumar Ramalingam ◽

Winston Thomas ◽

Nirmala Dheivamani ◽

Sathish Kumar Elumalai

Keyword(s):

Treatment Options ◽

Tertiary Care ◽

Hcv Infection ◽

Hcv Rna ◽

Genotype 1 ◽

Genotype 3 ◽

Hcv Genotype ◽

Chronic Hcv Infection ◽

Hcv Genotype 1 ◽

Chronic Hcv

Background: Worldwide, an estimated 71 million people are chronically infected with HCV, of which an estimated 2.1- 5.0 million are children aged ≤15 years. Children with chronic HCV infection have fewer treatment options than adults. Very few reports are available on HCV infection, treatment strategies and its outcome particularly in pediatric population. In this background, we evaluated the effectiveness and safety of Sofosbuvir/Ledipasvir in treating HCV infection in children.Methods: In this retrospective study, a total of 33 children with HCV positive status, 12 cases (children above 12 years of age) were selected for treatment. HCV-RNA quantitative assay, genotyping was carried out. Children above 12 years with HCV genotype 1 were treated with tablet ledipasvir-sofosbuvir (90/400 mg) orally once a day as morning dose for 12 weeks. Children with genotype 3 were treated with sofosbuvir 400 mg and weight based ribavirin for 24 weeks. Viral load was repeated after 12 weeks of completion of treatment with antivirals for sustained virological response (SVR 12).Results: Out of the 12 patients 11 patients had genotype 1 (5/11 had subtype-1a and 6/11 had subtype-1b) infection and only 1 patient has genotype 3 (subtype-3a). All of them attained SVR at the end of 12 weeks. The regimen was well tolerated and there were no side effects noted by the children and their caretakers. Drug compliance and the palatability of the drugs were good.Conclusions: Ledipasvir-sofosbuvir combination was highly effective at treating children with chronic HCV genotype 1 infection. The availability of an all oral, direct-acting antiviral regimen for paediatric population with chronic HCV would improve care for patients who currently have limited treatment options.

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Daclatasvir Plus Sofosbuvir With and Without Ribavirin for Previously Treated or Untreated Chronic HCV Infection Genotype 1, 2 and 4 in Togo

Annals of Clinical Oncology ◽

10.31487/j.aco.2020.03.01 ◽

2020 ◽

pp. 1-5

Author(s):

Gamal Shiha ◽

Folly Anyovi ◽

Reham Soliman ◽

Lidaw Déassoua Bawe ◽

Albert Theophane Yonli ◽

...

Keyword(s):

Liver Fibrosis ◽

Hcv Infection ◽

Efficacy And Safety ◽

Genotype 1 ◽

High Efficacy ◽

Previously Treated ◽

Chronic Hcv Infection ◽

Group 2 ◽

Chronic Hcv ◽

Group 1

Background: Daclatasvir (DCV) is a potent, pangenotypic nonstructural protein 5A inhibitor with demonstrated antiviral efficacy when combined with sofosbuvir (SOF) with or without ribavirin (RBV) in patients with chronic hepatitis C virus (HCV) infection. We are using SOF-DCV combination for large scale treatment. Objectives: The aim of the current study was designed to investigate the efficacy and safety of sofosbuvir/daclatasvir, with or without ribavirin for previously treated or untreated in treatment of HCV genotype 1, 2 and 4, as well as their effect on the liver fibrosis. Methods: One hundred twenty-seven patients with chronic HCV infection were categorized into 2 groups. The group 1 comprised treatment naïve patients, with total serum bilirubin ≤ 1.2mg/10-1L, serum albumin ≥ 3,5g/10-1L, ALAT ≥ 3N, ASAT≤ 2N and platelets count 150 x 109 /L. The group 2 included Peg-INF-alpha or sofosbuvir treatment-experienced patients or patients having at least 2 of the following characteristics: total bilirubin ≤ 1.2mg/10-1L, serum albumin ≥ 3,5g/10-1L, ALAT ≥ 3N, ASAT ≤ 2N and platelets count 150 x 109 /L. The first group was treated with sofosbuvir/daclatasvir for 12 weeks except sofosbuvir treatment experienced patients, who were treated with sofosbuvir/daclatasvir + ribavirin for 24 weeks, with generic medications: DCV 60 mg plus SOF 400 mg ± ribavirin (RBV) within the treatment of hepatitis C virus infection. Efficacy and safety were assessed, and baseline factors associated with sustained virological response at post-treatment week 12 (SVR12) were explored. Results: Sustained virological response (SVR12), was 95,8% in group 1 and 93,8% in group 2. Such high efficacy was accompanied with tolerable adverse effects as well as with significant improvement in liver fibrosis. Conclusion: SOF plus DCV with or without ribavirin achieved high efficacy and safety in HCV genotypes 1,2 and 4 patients. Their effect was accompanied with attenuation of liver fibrosis. Further wider-scale studies are needed to evaluate the actual role of IL 18 polymorphism in treatment response with Sofosbuvir/Daclatasvir.

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