Effectiveness of hepatitis B vaccination in chronic HCV patients after successful generic direct acting antiviral therapy: significance of isolated hepatitis B core antibodies

Background. There are few data on the combination of (pegylated-) interferon- (Peg-IFN-)α, ribavirin, and first-generation direct-acting antiviral agents (DAAs). Our aim was to describe the efficacy and safety of Peg-IFN-α, ribavirin, and boceprevir in hemodialysis patients.Patients. Six hemodialysis patients, chronically infected by genotype-1 HCV, were given Peg-IFN-α(135 µg/week), ribavirin (200 mg/d), and boceprevir (2400 mg/d) for 48 weeks.Results. At initiation of antiviral therapy, median viral concentration was 5.68 (3.78–6.55) log IU/mL. HCV RNA was undetectable in four of the six patients at week 4 and in all patients at week 24. A breakthrough was observed in two patients between weeks 24 and 48, and a third patient stopped antiviral therapy between weeks 24 and 48 because of severe peripheral neuropathy. At week 48, HCV RNA was undetectable in three patients. Of these, two patients relapsed within a month after antiviral therapy was stopped. Hence, only one patient had a sustained virological response; he was a previous partial responder. Overall, anemia was the main side effect.Conclusion. A triple antiviral therapy based on Peg-IFN-α, ribavirin, and boceprevir is not optimal at treating hemodialysis patients with chronic HCV infection. Studies using new-generation drugs are required in this setting.

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Non-invasive methods for the diagnosis of liver fibrosis in chronic HCV-infection

Journal Infectology ◽

10.22625/2072-6732-2021-13-1-58-65 ◽

2021 ◽

Vol 13 (1) ◽

pp. 58-65

Author(s):

A. I. Fazul’zyanova ◽

A. K. Husainova ◽

S. V. Tkacheva ◽

F. M. Yakupova

Keyword(s):

Liver Cirrhosis ◽

Liver Fibrosis ◽

Antiviral Therapy ◽

Prognostic Significance ◽

Hcv Infection ◽

Direct Acting Antiviral ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Direct Acting ◽

Severe Fibrosis

Objective: to study the values of fibrosis indices and transient elastometry in patients with chronic HCV infection who received antiviral therapy.Materials and methods: The study included 64 patients with chronic HCV infection who received antiviral therapy with direct-acting antiviral drugs or a combination of peginterferon and ribavirin.The fibrosis indices AAR, APRI and FIB-4 were calculated before the start of therapy and 6 months after its completion. Values of AAR>1, APRI≥1,5, and FIB-4≥1,45 were considered indicators of severe fibrosis. We studied the dynamics of fibrosis indices and elastometry values depending on the treatment regimen, their correlation and the prognostic significance of fibrosis indices in relation to elastometry.Results. Among patients treated with direct-acting antiviral drugs, a sustained virologic response was achieved in 100%, and peginterferon-containing regimen – in 85%. Elastometry and APRI and FIB-4 indices decreased in both groups. In patients without liver cirrhosis, the average elastometry after treatment decreased from 9,5±1,7 kPa to 6,7 ± 1.4 kPa (p = 0,0006). In patients with liver cirrhosis, the median of elastometry decreased from 20 to 11,7 kPa (p = 0,0006), the median of APRI decreased from 2,09 to 0,61 (p = 0,005), FIB-4 from 3,95 up to 2,22 (p = 0,022). The prognostic significance of FIB-4 in relation to elastometry before treatment was 81%, after – 82%.Conclusion. Successful etiotropic therapy leads to an improvement in values of liver fibrosis indices and transient elastometry in patients with HCV infection, including liver cirrhosis, regardless of the treatment regimen. The FIB-4 index showed the highest sensitivity and prognostic significance in determining severe fibrosis.

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