P076: The role of a hepatitis C virus vaccine: modelling the benefits alongside direct-acting antiviral treatments

AbstractThe treatment of chronic hepatitis C virus (HCV) infection has considerably evolved with the development of safe and well-tolerated combinations of direct-acting antiviral (DAA) drugs yielding high rates of infection cure. However, some patients fail to achieve a sustained virological response while receiving the most recent DAA combinations. Several waves of treatment failures have occurred concomitantly to the use of different drug combinations. The outcome of their retreatment strongly depends on the DAA(s) received and the retreatment regimen(s) available. This article discusses virological failure rates with the successive waves of HCV combination regimens, the reasons for failure, the role of HCV resistance, and current retreatment options. The triple combination of sofosbuvir, velpatasvir, and voxilaprevir for 12 weeks is the first-line retreatment strategy in patients previously exposed to DAAs. Difficult-to-retreat patients may benefit from the combination of sofosbuvir plus glecaprevir/pibrentasvir and/or the addition of ribavirin and/or longer retreatment duration.

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Ribavirin at the Era of Novel Direct Antiviral Agents for the Treatment of Hepatitis C Virus Infection: Relevance of Pharmacological Monitoring

Advances in Hepatology ◽

10.1155/2014/493087 ◽

2014 ◽

Vol 2014 ◽

pp. 1-13 ◽

Cited By ~ 7

Author(s):

Pierre Pradat ◽

Victor Virlogeux ◽

Marie-Claude Gagnieu ◽

Fabien Zoulim ◽

François Bailly

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Virological Response ◽

Antiviral Agents ◽

Area Under The Curve ◽

Direct Acting Antiviral ◽

Dose Adaptation ◽

Virological Relapse ◽

Direct Acting

Ribavirin is often used for the treatment of hepatitis C virus (HCV) infection. Although its mechanisms of action remain to be clearly elucidated, ribavirin plays a beneficial role for achieving virological response and decreasing the rate of virological relapse after treatment cessation. However, ribavirin may induce side effects leading to early treatment discontinuation. Among them, hemolytic anemia is the most frequent and results from intraerythrocyte accumulation. Pharmacological studies have shown that early ribavirin exposure assessed by the area under the curve (AUC) at day 0 and ribavirin trough concentration during the first three months of therapy were correlated with sustained virological response (SVR). These studies highlighted the relevance of ribavirin pharmacologic monitoring and early dose adaptation during therapy. Although the role of ribavirin within new direct acting antiviral (DAA) combinations will probably decrease in the future, its potential benefit in difficult-to-treat patients such as patients with severe hepatopathy or patients who failed triple therapy including patients with multiresistance will need to be further investigated.

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The Role of Hepatitis C Virus Core Antigen Testing in the Era of Direct Acting Antiviral Therapies: What We Can Learn from the Protease Inhibitors

PLoS ONE ◽

10.1371/journal.pone.0163900 ◽

2016 ◽

Vol 11 (10) ◽

pp. e0163900 ◽

Cited By ~ 11

Author(s):

Linh Thuy Nguyen ◽

Emma Gray ◽

Aisling O'Leary ◽

Michael Carr ◽

Cillian F. De Gascun ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Protease Inhibitors ◽

Core Antigen ◽

Direct Acting Antiviral ◽

Antiviral Therapies ◽

Virus Core ◽

Direct Acting ◽

Antigen Testing

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New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.264.cvr ◽

2017 ◽

Vol 26 (4) ◽

pp. 381-386

Author(s):

Mircea Manuc ◽

Carmen M. Preda ◽

Corneliu P. Popescu ◽

Cristian Baicuș ◽

Theodor Voiosu ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Users ◽

Antiviral Agent ◽

Virologic Response ◽

Advanced Fibrosis ◽

Direct Acting Antiviral ◽

Genotype 1B ◽

Direct Acting ◽

End Stage

Background & Aims: Literature data suggest that HCV genotype-1b is present in 93-99% of the Romanian patients infected with hepatitis C virus (HCV). We present the genotyping tests recently performed on patients with HCV and advanced fibrosis eligible for the Direct-Acting Antiviral (DAA) therapy, as well as the prevalence of these cases across Romania.Methods: The genotyping method was performed on 7,421 HCV patients with advanced fibrosis. The detection method was automatic real time PCR platform M2000 (Abbott). Every subject was introduced into a database including age, sex, county and address.Results: Genotype 1b was almost exclusively present: 7,392/7,421 (99.6%). Genotype 1b patients were 19.6% from Bucharest, 49% were males, with a median age of 60 years. Genotype non-1b was encountered in 29/7,421 subjects (0.4%), 62% were males, 69% from Bucharest and the median age was 52 years. Most of the subjects (75%) were in the 6th and 7th age decade. The prevalence of these cases varied significantly across Romanian counties: the highest was in Bucharest (61.3/105), Bihor (47/105), Iasi (46/105) and Constanța (43/105), and the lowest in Ilfov (2.8/105), Harghita (3.7/105), Covasna (5.4/105) and Maramureș (8.8/105) (p<0.001).Conclusions: Genotype 1b is encountered in 99.6% of patients with chronic hepatitis C and advanced fibrosis from Romania. The presence of genotypes non-1b is more common in Bucharest, in males and at a younger age. There are significant differences regarding the distribution of these cases across Romania: the highest rates are in Bucharest, Bihor, Iasi and Constanta.Abbreviations: BMI: body mass index; DAA: direct-acting antiviral agent; GT: genotype; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; IDU: intravenous drug users; MELD: model for end stage liver disease; NASH: non-alcoholic steatohepatitis; SVR; sustained virologic response.

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DIRECT ACTING ANTIVIRAL TREATMENT FOR CHRONIC HEPATITIS C VIRUS INFECTION. REAL WORLD EXPERIENCE IN AN IRISH PAEDIATRIC COHORT

10.26226/morressier.5ad774dcd462b80296ca674b ◽

2018 ◽

Author(s):

Karina Butler

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Antiviral Treatment ◽

Hepatitis C Virus Infection ◽

Direct Acting Antiviral ◽

Chronic Hepatitis C Virus ◽

Paediatric Cohort ◽

Direct Acting

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Faculty Opinions recommendation of Disparities in Initiation of Direct-Acting Antiviral Agents for Hepatitis C Virus Infection in an Insured Population.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733223819.793553798 ◽

2018 ◽

Author(s):

Norah Terrault

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Antiviral Agents ◽

Hepatitis C Virus Infection ◽

Direct Acting Antiviral ◽

Direct Acting ◽

Direct Acting Antiviral Agents

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Hepatitis C Virus Elimination is Not Attained in a Certain of Immunocompetent Patients Who Achieved Sustained Viral Response to Direct-Acting Antiviral Agents

SSRN Electronic Journal ◽

10.2139/ssrn.3214875 ◽

2018 ◽

Author(s):

Yijin Wang ◽

Huiying Rao ◽

Xiumei Chi ◽

Boan Li ◽

Liyuan Wu ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Antiviral Agents ◽

Sustained Viral Response ◽

Virus Elimination ◽

Viral Response ◽

Direct Acting Antiviral ◽

Direct Acting ◽

Direct Acting Antiviral Agents ◽

Immunocompetent Patients

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Efficacy of Direct-Acting Antiviral Combination Therapy in the Treat-ment of Hepatitis C Virus Among Kidney Transplant Patients

Anti-Infective Agents ◽

10.2174/2211352518999200703114432 ◽

2020 ◽

Vol 18 ◽

Author(s):

Mohammed Al Atbee ◽

Saad Shaheen Al-Taher ◽

Majid Alabbood

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Virus Infection ◽

Kidney Transplant ◽

Virological Response ◽

Hepatitis C Virus Infection ◽

Direct Acting Antiviral ◽

Transplant Patients ◽

Kidney Transplant Patients ◽

Direct Acting

Background: Up to date, there is no consensus on the best combination of direct-acting antiviral to treat hepatitis C virus in kidney transplant recipients. Objective: This study aims to analyze the efficacy of combination of sofosbuvir and ledipasvir regimen for treatment of hepatitis C virus infected kidney transplant patients. Method: A cross-sectional study conducted in a nephrology clinic and the Nephrology Center in Basrah Teaching Hospital from June 2015 to June 2018. Ledifos (90 mg Ledipasvir and 400 mg Sofosbuvir fixed-dose) was given as a single daily dose for all the participants for 12 weeks. Response for therapy was tested by follow up hepatitis C virus load at the end of 12 weeks and 24 weeks. The sustained virological response was defined as negative viral load of hepatitis C virus (aviremia) at the end of therapy. This study was done according to the Helsinki Congress. Results: A total of 60 (16 females) patients with renal transplantation and hepatitis C virus infection were included. Mean age was 40±6.2 years. A sustained virological response observed in all of the patients who received Ledifos after 12 and 24 weeks of therapy for all genotypes (1a, 1b and 4); p= 0.0001. Genotype 1a was more prevalent among males, 34 (56.6%); p= 0.0001, and it was the most common genotype tested negative serologically, 11 (18.3%). Conclusion: Ledifos therapy is effective and safe option for the treatment of hepatitis C virus infection in the post–renal transplant setting.

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