Effect of Direct Acting Anti-Viral Drugs on Insulin Resistance and sensitivity Among Egyptian Chronic HCV Infected Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tareq M Yosef ◽  
Wesam A Ibrahim ◽  
Sarah A El-Nakeep ◽  
Ahmed M ElGhandour ◽  
Soha saied attiya
Keyword(s):  
Insulin Resistance ◽  
Fasting Blood Glucose ◽  
Hcv Infection ◽  
Military Hospital ◽  
Hcv Rna ◽  
Matsuda Index ◽  
Treatment Naïve ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact

Abstract Background Hepatitis C virus (HCV) infection is a worldwide infection, affecting up to 185 million people across the world. It carries a high risk for developing liver cirrhosis, hepatocellular carcinoma (HCC) and liver-related deaths. Aim of the Work to assess the impact of direct acting anti-viral drugs on the status of insulin resistance and sensitivity in non-diabetic chronic HCV infection patients Patients and Methods study included 100 treatment naive patients with chronic infection of HCV attending the out-patient clinic at Gastro-enterology and Hepatology Department, Ain shams University and Kobry El Kobba Military Hospital between September 2017 till June 2019. Patients were diagnosed by HCV antibodies & HCV RNA by PCR. Results The fasting blood glucose, seum insulin and HbA1c were significantly decreased between the baseline and after SVR12. The 2Hrs PP was significantly increased between the baseline and after SVR12. The HOMA-IR showed significant decrease between the baseline and SVR12. The QUICKI and Matsuda Index showed significant increase at SVR12. Conclusion HOMA-IR, QUICKI and Matsuda index showed significant improvement between the baseline and after SVR12.

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.

scholarly journals French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cécile Brouard ◽  
Josiane Pillonel ◽  
Marjorie Boussac ◽  
Victor de Lédinghen ◽  
Antoine Rachas ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Substantial Impact ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact

Abstract Background Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs). Methods The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. Results Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7 to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016). Conclusions This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

Direct-acting antivirals inducing HCV-RNA sustained suppression improve Xerophthalmia in HCV-infected patients

2021 ◽  
Vol 16 ◽  
Author(s):  
Benedetto Caroleo ◽  
Lidia Colangelo ◽  
Maria Donato ◽  
Marco Balestrieri ◽  
Mauro Soda ◽  
...  
Keyword(s):  
Randomized Study ◽  
Hcv Infection ◽  
Laboratory Evaluation ◽  
Hcv Rna ◽  
Direct Acting Antivirals ◽  
Open Label ◽  
Dry Eyes ◽  
Group 2 ◽  
Direct Acting ◽  
The Impact

Background: Hepatitis C virus (HCV) infection represents a global problem, and it is related to both hepatic and extra-hepatic manifestations (e.g., xerophthalmia). New direct-acting antivirals (DAAs), IFN-free treatments, are commonly used to manage HCV infection. However, the impact of new DAAs on dry eyes (xerophthalmia) is lacking. In this study, we evaluated its incidence in HCV patients and the effect of DAAs on this manifestation. Methods: We performed an observational open-label non-randomized study in HCV patients from 01 April 2018 to 01 June 2020. Results : Patients who satisfied the inclusion criteria underwent clinical and laboratory evaluation, Schirmer's test, and Break-up time test. Enrolled patients were divided in two groups: Group 1: HCV patients with xerophthalmia: 24 patients (16 male and 8 female), HCV-RNA 2,685,813 ± 1,145,698; Group 2: HCV patients without xerophthalmia: 35 patients (19 male and 16 female), HCV-RNA 2,614,757 ± 2,820,433. The follow-ups (3 and 6 months after the enrollment) documented an improvement in both eyes’ manifestations and HCV-infection (HCV-RNA undetected). Conclusion: In conclusion, in this study, we reported that xerophthalmia could appear in HCV patients, and DAAs treatment reduces this manifestation without the development of adverse drug reactions.

scholarly journals French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

2020 ◽  
Author(s):  
Cécile Brouard ◽  
Josiane Pillonel ◽  
Marjorie Boussac ◽  
Victor de Lédinghen ◽  
Antoine Rachas ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Substantial Impact ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact

Abstract Background: Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs).Methods: The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System.Results: Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7% to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016).Conclusions: This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

scholarly journals French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

2020 ◽  
Author(s):  
Cécile Brouard ◽  
Josiane Pillonel ◽  
Marjorie Boussac ◽  
Victor de Lédinghen ◽  
Antoine Rachas ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Substantial Impact ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact

Abstract Background: Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs).Methods: The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. Results: Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7% to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016).Conclusions: This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

scholarly journals B-type natriuretic peptide (BNP) in HCV-positive Egyptian patients: the impact of HCV eradication on plasma BNP levels

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ali Nada ◽  
Aliaa Sabry ◽  
Naglaa S. Elabd ◽  
Azza M. Abdu Allah ◽  
Nada Elnaidany ◽  
...  
Keyword(s):  
Natriuretic Peptide ◽  
Antiviral Agents ◽  
Hcv Infection ◽  
Cardiac Monitoring ◽  
Hcv Rna ◽  
Laboratory Assessment ◽  
Mean Values ◽  
Egyptian Patients ◽  
Chronic Hcv ◽  
The Impact

Abstract Background Chronic hepatitis C virus (HCV) infection represents a major health-related burden in Egypt. HCV is considered as a major cardiovascular risk factor. BNP (B-type natriuretic peptide) has been determined as a credible diagnostic and prognostic cardiac biomarker. We aimed to assess plasma BNP in HCV-positive Egyptian patients prior and after HCV eradication by direct-acting antiviral agents (DAAs) therapy. Eighty-nine chronic HCV-positive patients were enrolled in our prospective research. They were provided with DAAs therapy in the form of sofosbuvir and daclatasvir without or with ribavirin for 12 weeks. History, clinical evaluation, and laboratory assessment: CBC, liver and kidney function tests, viral markers (HCVAb, HBVsAg, and HIVAb) by ELISA, HCV RNA by real-time PCR, and BNP by ELISA were assessed. FIB-4 and aspartate aminotransferase-to-platelet ratio index (APRI) scores were ranked. Results Plasma BNP displayed a non-significant (p = 0.124) increase of its serum mean values in post eradication of HCV than its baseline values. Baseline BNP exhibited a significant positive correlation with FIB4 (r = 0.411, P < 0.001) and APRI score (r = 0.418, p < 0.001) with a considerably negative correlation with platelets (r = − 0.274, p = 0.009), in addition to higher pretreatment BNP values in cirrhotic than in non-cirrhotic patients (p < 0.001), while non-significant relations were found regarding sex, BMI, and drug regimen (with or without ribavirin) (p = 0.950, 0.845, and 0.738, respectively). Additionally, plasma BNP values considerably decreased post-treatment in patients presented with higher baseline BNP values and more advanced liver disease (higher FIB4, APRI, and the presence of liver cirrhosis). Conclusion Our findings propose on the one side, the necessity of cardiac monitoring during chronic HCV infection and, on the other, the valuable impacts of HCV eradication on HCV-associated cardiac morbidities.

scholarly journals French hepatitis C care cascade: substantial impact of direct-acting antivirals, but the road to elimination is still long

2020 ◽  
Author(s):  
Cécile Brouard ◽  
Josiane Pillonel ◽  
Marjorie Boussac ◽  
Victor de Lédinghen ◽  
Antoine Rachas ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Antiviral Treatment ◽  
Hcv Infection ◽  
World Health ◽  
Direct Acting Antivirals ◽  
Substantial Impact ◽  
Chronic Hcv Infection ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact

Abstract Background: Hepatitis C virus (HCV) elimination by 2030, as targeted by the World Health Organization (WHO), requires that 90% of people with chronic infection be diagnosed and 80% treated. We estimated the cascade of care (CoC) for chronic HCV infection in mainland France in 2011 and 2016, before and after the introduction of direct-acting antivirals (DAAs).Methods: The numbers of people (1) with chronic HCV infection, (2) aware of their infection, (3) receiving care for HCV and (4) on antiviral treatment, were estimated for 2011 and 2016. Estimates for 1) and 2) were based on modelling studies for 2011 and on a virological sub-study nested in a national cross-sectional survey among the general population for 2016. Estimates for 3) and 4) were made using the National Health Data System. Results: Between 2011 and 2016, the number of people with chronic HCV infection decreased by 31%, from 192,700 (95% Credibility interval: 150,900-246,100) to 133,500 (95% Confidence interval: 56,900-312,600). The proportion of people aware of their infection rose from 57.7% to 80.6%. The number of people receiving care for HCV increased by 22.5% (representing 25.7% of those infected in 2016), while the number of people on treatment increased by 24.6% (representing 12.1% of those infected in 2016).Conclusions: This study suggests that DAAs substantially impact CoC. However, access to care and treatment for infected people remained insufficient in 2016. Updating CoC estimates will help to assess the impact of new measures implemented since 2016 as part of the goal to eliminate HCV.

scholarly journals Epidemiology and Elimination of HCV-Related Liver Disease

Viruses ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 545 ◽  
Author(s):  
Pierre Pradat ◽  
Victor Virlogeux ◽  
Eric Trépo
Keyword(s):  
Hcv Infection ◽  
World Health ◽  
Hcv Rna ◽  
Direct Acting Antiviral ◽  
Beneficial Effects ◽  
Related Liver Disease ◽  
Health Organization ◽  
Chronic Hcv ◽  
Unsafe Injection ◽  
Direct Acting

Hepatitis C virus (HCV) infection, defined by active carriage of HCV RNA, affects nearly 1.0% of the worldwide population. The main risk factors include unsafe injection drug use and iatrogenic infections. Chronic HCV infection can promote liver damage, cirrhosis and hepatocellular carcinoma (HCC) in affected individuals. The advent of new second-generation, direct-acting antiviral (DAA) agents allow a virological cure in more than 90% of treated patients, and therefore prevent HCV-related complications. Recently, concerns have been raised regarding the safety of DAA-regimens in cirrhotic patients with respect to the occurrence and the recurrence of HCC. Here, we review the current available data on HCV epidemiology, the beneficial effects of therapy, and discuss the recent controversy with respect to the potential link with liver cancer. We also highlight the challenges that have to be overcome to achieve the ambitious World Health Organization objective of HCV eradication by 2030.

Sign in / Sign up

Export Citation Format

Share Document