Clinical significance of detectable and quantifiable HCV RNA at the end of treatment with ledipasvir/sofosbuvir in GT1 patients

Background & Aims: This study aimed to assess the changes in platelet counts of patients with liver cirrhosis due to chronic HCV, who achieved sustained virological response (SVR) after taking direct acting antivirals (DAAs) in a large cohort study in Egypt. Methods: This multicenter observational retrospective study was carried out on 2500 chronic hepatitis C virus (HCV) infected patients who achieved (SVR) after treatment with direct acting antiviral drugs (DAA). HCV infection was confirmed by positive PCR for HCV RNA infection. SVR was defined as a negative PCR test for HCV-RNA 12 weeks after completion of DAA therapy. Platelets count was measured before therapy, during therapy, at the end of treatment, and 12 weeks after the end of the treatment. Results: There were 2186 patients enrolled in the study; 1866 (85.4%) were treatment naïve. There were 1006 (46%) males and 1180 (54%) females. Mean age was 50.82± 11.66 years, 2142 (98 %.0) patients achieved SVR, 2118 (96.9%) patients had Child -Pugh class A cirrhosis, and 68 (3.1%) had Child -Pugh class B liver cirrhosis. A significant increase of the platelets count was detected at the end of treatment in comparison to the pretreatment levels (P<0.001), and after achieving SVR (P <0.001) when compared to the pretreatment values. Conclusion: Improvement of platelets count occurs after HCV therapy with DAAS in patients with liver cirrhosis. These results suggested that HCV eradication may have a role in improvement of platelet count.

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HCV Core Antigen as an alternative test to Quantitative HCV RNA for assessment of SVR in Chronic HCV infected patients treated with Direct Acting Antiviral agents

QJM ◽

10.1093/qjmed/hcaa052.025 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

S M Mohamed ◽

N I Musa ◽

R S Ghait ◽

B M Abdelrhiem

Keyword(s):

Antiviral Agents ◽

Virologic Response ◽

Hcv Infection ◽

Core Antigen ◽

Hcv Rna ◽

Viral Kinetics ◽

Direct Acting Antiviral ◽

Hcv Core Antigen ◽

End Of Treatment ◽

Direct Acting

Abstract Background and aims Widespread use of direct-acting antiviral (DAA) agents to treat patients with hepatitis C virus (HCV) infection has reduced the need for monitoring of HCV-RNA levels, because viral kinetics do not predict sustained virologic response (SVR) to these drugs. However, the performance of cheaper tests, such as the assay to quantify HCV core antigen (HCV Ag), has not been determined. This study was aimed at investigating the accuracy of the HCV Ag test in predicting which patients receiving DAAs will achieve SVR at week 12 (SVR12). Methods We performed a prospective study on 90 patients, chronically infected with HCV, receiving DAAs therapy from different NCCVH centers in Cairo during the period from August 2017 to June 2018. We collected blood samples and measured the levels of HCV core Ag and HCV-RNA at baseline and 12 weeks after end of treatment. We compared the ability of these assays to predict which patients would have SVR12. Results The median baseline level of HCV-RNA was 1688529.6 ± 994697.3 IU/ml (range, 312700 IU/ml to 3491100 IU/ml) and HCV Ag was 179.2 ± 83.5 pg/ml (range, 33.5 pg/ml to 315.6 pg/ml). HCV Ag became undetectable in 92.2% 12 weeks after the end of treatment. HCV-RNA became undetectable in 87.8% at the end of treatment (P<.0001). 79 out of 90 patients (87.8%) achieved an SVR12; the test for HCV Ag identified 63.6% of these patients. Conclusions Tests that measure HCV Ag monitor efficacy of DAA therapy for HCV infection as well as assays that measure HCV-RNA, and hence could be recommended for clinical practice.

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Analysis of Monocytic and Granulocytic Myeloid-Derived Suppressor Cells Subsets in Patients with Hepatitis C Virus Infection and Their Clinical Significance

BioMed Research International ◽

10.1155/2015/385378 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Gang Ning ◽

Lanhui She ◽

Lirong Lu ◽

Ying Liu ◽

Yingfu Zeng ◽

...

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Clinical Significance ◽

Suppressor Cells ◽

Hcv Rna ◽

Myeloid Derived Suppressor Cells ◽

Hepatitis C Virus Infection ◽

Cell Responses ◽

Hla Dr ◽

Healthy Donors

Myeloid-derived suppressor cells (MDSCs) have been shown to inhibit T-cell responses in many diseases, but, in hepatitis C virus (HCV) infected patients, MDSCs are still poorly studied. In this assay, we investigated the phenotype and frequency of two new populations of MDSCs denoted as monocytic and granulocytic MDSCs (M-MDSCs and G-MDSCs) in HCV infected patients and analyzed their clinical significance in these patients respectively. We found that the frequency of CD14+HLA-DR-/lowcells (M-MDSCs) from HCV infected patients (mean ± SE, 3.134% ± 0.340%) was significantly increased when compared to healthy controls (mean ± SE, 1.764% ± 0.461%) (Z= −2.438,P= 0.015), while there was no statistical difference between the frequency ofHLA-DR-/lowCD33+CD11b+CD15+(G-MDSCs) of HCV infected patients and healthy donors (0.201% ± 0.038% versus 0.096% ± 0.026%,P> 0.05), which suggested that HCV infection could cause the proliferation of M-MDSCs instead of G-MDSCs. Besides, we found that the frequency of M-MDSCs in HCV infected patients had certain relevance with age (r= 0.358,P= 0.003); patients older than 40 years old group (mean ± SE, 3.673% ± 0.456%) had a significantly higher frequency of M-MDSCs than that of age less than 40 years old group (mean ± SE, 2.363% ± 0.482%) (Z= −2.685,P= 0.007). The frequency of M-MDSCs, however, had no correlation with HCV RNA loads, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the level of liver inflammation degree.

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VIROLOGICAL RESPONSES OF VELPATASVIR/SOFOSBUVIR IN PATIENTS WITH HCV GENOTYPE 3

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i1.397 ◽

2020 ◽

Vol 11 (1) ◽

pp. 9-14

Author(s):

Muhammad Sarfraz ◽

Arshad Rabbani ◽

Muhammad Shahzad Manzoor ◽

Benish Adil

Keyword(s):

Treatment Response ◽

Sustained Virological Response ◽

Virological Response ◽

Hcv Rna ◽

Rapid Virological Response ◽

Genotype 3 ◽

Hcv Genotype ◽

End Of Treatment ◽

Treatment Naïve ◽

Hcv Genotype 3

BACKGROUND & OBJECTIVE: The role of Velpatasvir/Sofosbuvir in the treatment of hepatitis C virus type 3 infection is evaluated in terms of virologic responses. i.e Rapid Virological Response (RVR) End of treatment response (ETR) and Sustained virological response (SVR 12). METHODOLOGY: This was a descriptive case study conducted in Liver OPD of Benazir Bhutto Hospital during 01 November 2018 to 30 April 2019 , in which 100 patients of HCV were enrolled, all of them had HCV genotype 3 infection. Every patient was treated with combination of Velpatasvir/Sofosbuvir 100mg/400 mg Once Daily as part of treatment regimen of HCV infection for 12 weeks. Pre-treatment HCV RNA QUANTITATIVE PCR was done, which was repeated on 4, 12 weeks of treatment and then 12 weeks post treatment. RESULTS: Among 100 patients, 51 (51%) were male and 49 (49%) were females. Mean age of patients was 43.2 ± 10.4 years (mean ± SD). Mean BMI of enrolled patients was 21.34 ± 2.40 kg/m2. 33% patients were cirrhotic while 67% were non cirrhotic. 53% patients were treatment experienced while 47% were treatment naïve. Rapid Virological Response (RVR) was achieved in 92%, End of treatment response (ETR) was achieved in 96%, while Sustained Virological response (SVR12) was achieved in 99% patients. The results were stratiﬁed according to age, gender and BMI. There was no eﬀect of these parameters on the ﬁnal results. CONCLUSION: Virological response (RVR, ETR, SVR12) of Velpatsvir /Sofosbuvir and Ribavirin is encouraging.

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