Indolent B-Cell Lymphomas Treated Upfront with Antiviral Therapy: a Series of 13 Patients

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2876-2876
Author(s):  
Andrea Ferrario ◽  
Alessio Aghemo ◽  
Maria Cecilia Goldaniga ◽  
Michele Merli ◽  
Daniele Vincenti ◽  
...  
Keyword(s):  
B Cell ◽  
Antiviral Therapy ◽  
Virologic Response ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Low Grade ◽  
Who Grade ◽  
Genotype 1B ◽  
Genotype 2

Abstract Abstract 2876 Background: HCV infection has been demonstrated to be involved in clonal B cell proliferation and in the subsequent development of non-Hodgkin's lymphoma (NHL). The regression of NHL after antiviral treatment is considered an indirect evidence of this pathogenetic relationship. Aim: to evaluate clinical course of patients affected by HCV infection (serology and HCV RNA positive) and low grade B-cell NHL (LG-NHL), not needing immediate treatment (absence of B symptoms, bulky disease or symptomatic tumor mass and lymphocyte doubling time less than 6 months) and treated upfront with antiviral therapy alone. Method: From 2006 to 2010, 13 patients, affected by LG- NHL at diagnosis have been treated with pegylated interferon (PegIFNa2a, 100–180 mcg weekly) and ribavirin (Rbv, 800–1200 mg daily) for a median treatment period of 6 months (6-18 months). Two patients are still in treatment. M/F ratio was 1.6 and median age was 59 years (range 51–73). The study included 9 marginal zone lymphomas (MZL: 2 splenic MZL, 7 extranodal non gastric MZL), 3 LG-NHL NOS and 1 lymphoplasmacytic lymphoma/Waldenstrom's macroglobulinemia (LPL). Cryoglobulin were present in five patients. 7 pts had genotype 2, 5 pts genotype 1b, one not assessed; HCV infection was detected before lymphoma diagnosis in 9 pts and at lymphoma onset in 4 pts. Only 2 patients have previously received other combinations of antiviral therapy. Virologic response was assessed monthly by HCV-RNA polymerase chain reaction (PCR) and hematologic response was evaluated according to International Working Group response criteria (Cheson et al. J Clin Oncol. 2007) at the end of antiviral therapy. Results: Eleven patients completed the planned treatment course. Sustained virologic response (SVR) was achieved in 9 patients (6 with genotype 2); viremia clearance was achieved in a median period of 2 months (1-6). Among patients that gained a SVR, 5 achieved a complete response (CR) (3 genotype 2, 1 1b, one not assessed), one (genotype 2) partial response (PR), and 3 (2 genotype 2 and one genotype 1b) presented stable disease (SD). The remaining patients obtained only a reduction of viremia: one presented a SD and one was in PR. The treatment was well tolerated without any WHO grade III-IV toxicity. Among patients that completed treatment program, more frequent toxicity was haematological (one patient developed a WHO grade 1 anemia and one patients developed WHO grade 1 anemia and grade 2 neutropenia). After a median follow up of 17 months from the end of therapy (range 3–44), considering the 9 patients in SVR, only 2 (1 CR and 1 PR) progressed, maintaining SVR and one lost SVR maintaining SD. Patients that obtained only a reduction of viremia, maintained their hematologic status. Conclusion: We described a high CR rate in patients that obtained SVR after antiviral therapy (55%); the relationship between hematologic and viral response during follow up is not always stringent. We confirm that antiviral therapy could be considered as frontline therapeutic option in cases of HCV-related LG-NHL not requiring immediately immunochemotherapy. Disclosures: No relevant conflicts of interest to declare.

Antiviral treatment in Hepatitis C Virus (HCV)- related low grade non-Hodgkin lymphoma: An update of a multicenter study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17526-17526
Author(s):  
D. Vallisa ◽  
P. Bernuzzi ◽  
A. Lazzaro ◽  
E. Trabacchi ◽  
A. Arcari ◽  
...  
Keyword(s):  
Viral Load ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Antiviral Treatment ◽  
Low Grade ◽  
Viral Genotype ◽  
Non Hodgkin Lymphoma ◽  
Hematological Response ◽  
Genotype 2

17526 Background: HCV is largely diffuse in North-western Europe and U.S.A. It has been shown to play a role both in hepatocellular carcinoma and in B-cell non-Hodgkin lymphoma (B-NHL). Up to now the exact biological mechanisms that could explain the lymphomagenic role of the virus are under study. Methods: We have previously published a series of 13 patients, affected by low grade B-cell NHL and characterized by an indolent course (i.e. doubling time less than 1 year, no bulky disease), who underwent antiviral treatment only with peghilated interferon and ribavirin (peghilated interferon 50–70 microgram weekly, ribavirin 1000–1200 mg daily). Now we report the second update of this study. Up to now 17 patients are evaluable with a mean follow up of 12.1 ± 8 months (range 2–31 months). Results: Eight patients experienced complete or good partial haematological response that has lasted up to now with a mean follow up of 19,5 months, among them 3 splenic marginal lymphomas, 2 nodal marginal, 1 follicular lymphoma, 1 plasmocytoid and 1 marginal extranodal lymphoma. Three other patients achieved a long lasting partial response. The only one relapse (marginal nodal lymphoma) occurred about one year after the end of treatment, hematological relapse happened together with viral relapse, the lymphoma reappeared as highly chemo resistant high grade lymphoma, and two months later the patient died. Interestingly complete and good partial responses were more likely to be seen in viral genotype 2 (p = 0.04) and were strictly related to the decrease of viral load under treatment (p = 0.005). Toxicity causes the stop of the treatment in 3 patients; however one of them was able to achieve complete hematological response. Time to achieve hematological response was quite long (mean 8 ± 4.5 months). Conclusions: This kind of experience strongly provides a role for antiviral treatment in patients affected by HCV related low grade B-cell NHL. Especially viral genotype 2 infection may be considered a good prognostic marker for hematological response as well as decrease of viral load under treatment. Toxicity in our hands was however significant and further experiences are warranted in order to better modulate antiviral therapy doses. No significant financial relationships to disclose.

Efficacy of antiviral therapy for chronic hepatitis C in children

2021 ◽  
Vol 19 (1) ◽  
pp. 119-123
Author(s):  
O.V. Churbakova ◽  
◽  
D.V. Pechkurov ◽  
T.A. Zhilyakova ◽  
V.G. Akimkin ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Sustained Virologic Response ◽  
Disease Onset ◽  
Virologic Response ◽  
New Drugs ◽  
Hcv Rna

Objective. To analyze the efficacy of antiviral therapy for chronic hepatitis C (HCV) in children. Patients and methods. This study included 58 children aged between 3 and 17 years who had never received antiviral therapy (AVT) before and were treated in the Pediatric Department for Infectious Diseases, N.A.Semashko City Clinical Hospital No 2 (Samara). The inclusion criteria were as follows: confirmed CHC diagnosis and follow-up for at least one year. We analyzed treatment outcomes during an 8-year period, as well as the dynamics of clinical and biochemical parameters in children with HCV depending on their response to AVT. Results. Sustained virologic response (SVR) was achieved in 19 out of 58 children (32.8%) after 24 weeks of therapy and 30 out of 58 children (51.7%) after 48 weeks of therapy. In these children, viral genotypes were distributed as follows: 1b genotype in 19 participants (32.7%), 2a genotype in 4 participants (6.9%), and 3a genotype in 7 participants (12.1%). Twenty-eight patients (71.8%) remained HCV RNA positive, including 1 child with 2a genotype (2.6%), 3 children with 3a genotype (7.7%), and 24 children with 1b genotype (61.5%). Three years after treatment completion, 25 out of 58 patients (43.1%) had SVR. During 8 years of follow-up, 17 out of 30 children (56.7%) maintained SVR. Conclusion. Five out of 58 study participants (8.6%) developed F1–F2 liber fibrosis (METAVIR scale) over 8 years of follow-up. Two out of 58 children with HCV (3,5%) were found to have liver cirrhosis 6.6 ± 1.15 years after the disease onset (minimum – 4 years; maximum – 8 years). New drugs and treatment regimens are needed to increase the SVR rate in children. Key words: children, outcomes, sustained virologic response, chronic hepatitis C

Anti-Lymphoma Activity of Interferon-Free Antiviral Treatment in Patients with Indolent B-Cell Lymphomas Associated with Hepatitis C Virus Infection

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3938-3938 ◽  
Author(s):  
Luca Arcaini ◽  
Caroline Besson ◽  
Jan Peveling-Oberhag ◽  
Véronique Loustaud-Ratti ◽  
Sara Rattotti ◽  
...  
Keyword(s):  
B Cell ◽  
Virological Response ◽  
Marginal Zone ◽  
Antiviral Treatment ◽  
Marginal Zone Lymphoma ◽  
Hcv Infection ◽  
Low Grade ◽  
Lymphoplasmacytic Lymphoma ◽  
Hematological Response

Abstract Background: The regression of hepatitis C virus (HCV)-associated lymphoma with antiviral treatment (AT) is the strongest argument in favour of an etiological link between lymphoma, especially marginal zone lymphoma (MZL), and HCV infection. In addition, the favourable impact of AT on overall survival of these patients has been reported (Arcaini 2014, Michot 2015). Although there is a clear association across the studies between the lymphoma regression and the clearance of HCV, the direct anti-lymphoma activity of interferon (IFN) cannot be ruled out. AT is undergoing a revolution: new antiviral drugs, including direct-acting antiviral (DAA) like sofosbuvir (SOF) cure more than 90% of infections. However, data on new IFN-free regimens in HCV-associated lymphoproliferative disorders are scanty and based on clinical reports (Rossotti 2015; Sultanik 2015; Carrier 2015). Patients and Methods: We analyzed virological and hematological response of 26 patients (pts) with indolent B-cell non-Hodgkin lymphomas (NHL) or chronic lymphocytic leukemia (CLL) and HCV infection treated with an IFN-free AT. We included the 5 cases reported in literature (Rossotti 2015; Sultanik 2015; Carrier 2015) with updated follow up. Results: Histological, virological and hematological features are summarized in Table 1. Histology distribution was as follows: 12 splenic MZL, 6 extranodal MZL of MALT, 2 leukemic MZL, 2 nodal MZL, 2 CLL/SLL, 1 lymphoplasmacytic lymphoma (LPL) and 1 low grade NHL NOS. Cryoglobulins were present in 13 (symptomatic cryoglobulinemia in 5). HCV genotype was 1 in 15 pts, 2 in 4 pts, 3 in 3 pts and 4 in 2 pts, NA in 2 pts. Three pts previously received chemotherapy and 4 underwent IFN-based therapy before. Twenty-four pts received a SOF-based regimens (SOF + simeprevir in 10, SOF + ribavirin in 5, SOF + daclatasvir in 8, SOF + ledipasvir in 1) and 2 pts other regimens (ombitasvir + paritaprevir + ritonavir + ribavirin and faldaprevir + deleobuvir + ribavirin). In one pt with renal MZL 4 rituximab (R) doses have been added to SOF + simeprevir. Median AT duration was 12 weeks (range: 6-24). At time of present analysis, virological response is available in 21 pts while hematological response has been assessed in 20 pts. A sustained virological response has been obtained in 20 pts; hematological response has been observed only in pts with HCV clearance: in particular 8 pts (all MZL) achieved a complete response and 4 (all MZL) a partial response (comprising one treated also with R) while 5 had stable disease (response by histology is summarized in Table 1). In 7 pts response duration is +1 mo (in 2 pts), +2 mo (in 1 pt), +6 mo (in 3 pts), and +22 mo (in 1 pt); 6 pts (60%) cleared cryoglobulins after AT. After a median follow-up of 6 mo (range: 1-28), 2 pts progressed: one pt shifted to DLBCL and one pt without virological response progressed and died of lymphoma; another pt with hematological CR died of metastatic hepatocellular carcinoma 8 mo after AT. Complete data for all pts will be presented at the meeting. Conclusions: Our study shows that a significant rate of hematological response can be achieved in HCV-associated MZL also with IFN-free AT. These data are a strong rationale for planning prospective trials with DAA in this setting. Table 1. Features of 26 pts with NHL associated with HCV infection treated with IFN-free regimen and lymphoma response by histology N % Age, median (range) 26 57 (40-78) M/F 11/15 42/58 - Marginal-zone lymphoma SplenicNodalExtranodal of MALTLeukemic MZL- CLL - Lymphoplasmacytic lymphoma - Low-grade B-cell NHL NOS 22 12 2 6 2 2 1 1 84.7 46.2 7.7 23.1 7.7 7.7 3.8 3.8 Ann Arbor stage III-IV 19 73 B symptoms 4 15 ECOG 0 1 2 3 11 10 0 1 50 45 0 5 BM involvement 14 54 Extranodal disease 17 65 Splenic involvement 13 50 Liver involvement 5 19 Nodal disease 15 58 Bulky disease 7 27 Leukemic disease 9 35 Elevated LDH 8/22 36 Elevated b2-microglobulin 8/10 80 Albumin <3.5 g/dl 3/21 14 Serum MC 9/22 41 HCV genotype - 1 - 2 - 3 - 4 15 4 3 2 63 17 12 8 Cryoglobulins 13 50 Symptomatic cryoglobulinemia 5/13 38 HBsAg 1/25 4 Anti-HBc 4/25 16 Lymphoma response by histology- Marginal-zone lymphoma (n=17) Splenic (n=9)Nodal (n=1)Extranodal of MALT (n=5)Leukemic MZL (n=2)- CLL (n=2) - Lymphoplasmacytic lymphoma (n=1) CR/PR/SD/Progression 8/4/2/3 4/2/2/1 1/-/-/- 2/1/-/2 1/1/-/- -/-/2/- -/-/1/- Disclosures No relevant conflicts of interest to declare.

The Role of Antiviral Treatment in Hepatitis C Virus (HCV)-Related Non-Hodgkin Lymphoma: An Update of a Multicenter Study.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1509-1509
Author(s):  
Daniele Vallisa ◽  
Patrizia Bernuzzi ◽  
Luca Arcaini ◽  
Antonio Lazzaro ◽  
Elena Trabacchi ◽  
...  
Keyword(s):  
Viral Load ◽  
B Cell ◽  
Antiviral Treatment ◽  
Low Grade ◽  
Viral Genotype ◽  
Non Hodgkin Lymphoma ◽  
Hematological Response ◽  
Genotype 2

Abstract HCV is largely, although not homogenously, diffuse in North-western Europe and U.S.A. It has been shown to play a role both in hepatocellular carcinoma and in B-cell non-Hodgkin lymphoma (B-NHL). Up to now the exact biological mechanisms that could explain the lymphomagenic role of the virus are unknown. We have previously published a series of 13 patients, affected by low grade B-cell NHL and characterized by an indolent course (i.e. doubling time less than 1 year, no bulky disease), who underwent antiviral treatment only with peghilated interferon and ribavirin (peghilated interferon 50–70 microgram weekly, ribavirin 1000–1200 mg daily). Now we report an update of this study. Up to now we were able to evaluate 16 patients with a mean follow up of 15,1± 7,6 months (range 2–28 months). Eight patients experienced complete or good partial haematological response that has lasted up to now with a mean follow up of 16,5 months, among them 3 splenic marginal lymphomas, 2 nodal marginal, 1 follicular lymphoma, 1 plasmocytoid and 1 marginal extranodal lymphoma. Three other patients achieved a long lasting partial response. The only one relapse (marginal nodal lymphoma) occurred about one year after the end of treatment, hematological relapse happened together with viral relapse, the lymphoma reappeared as highly chemo resistant high grade lymphoma, and two months later the patient died. Interestingly complete and good partial responses were more likely to be seen in viral genotype 2 (p=0.035) and were strictly related to the decrease of viral load under treatment (p=&lt;0.001). Toxicity causes the stop of the treatment in 3 patients; however one of them was able to achieve complete hematological response. Time to achieve hematological response was quite long (mean 8± 4,5 months). This kind of experience strongly provides a role for antiviral treatment in patients affected by HCV related low grade B-cell NHL. Especially viral genotype 2 infection may be considered a good prognostic marker for hematological response as well as decrease of viral load under treatment. Toxicity in our hands was however significant and further experiences are warranted in order to better modulate antiviral therapy doses.

Predictors of Sustained Virological Response After Antiviral Therapy for Chronic Hepatitis C In Patients with Hemophilia: The Role of the Interleukin-28B (IL28B) Polymorphism

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2276-2276
Author(s):  
Maria Elisa Mancuso ◽  
Alessio Aghemo ◽  
Elena Santagostino ◽  
Maria Grazia Rumi ◽  
Raffaele Bruno ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Virologic Response ◽  
Hcv Infection ◽  
Spontaneous Clearance ◽  
Genotype 1 ◽  
Hcv Genotype ◽  
Genotype 2

Abstract Abstract 2276 Background: Chronic hepatitis C is the main cause of morbidity and mortality in patients with hemophilia. HCV eradication is the only approach that can halt disease progression and it may be attempted by using antiviral therapy, the standard of care being represented by the combination of pegylated interferon (Peg-IFN) plus ribavirin. Sustained virologic response (SVR) is defined by undetectable HCV-RNA in serum 6 months after therapy completion. The likelihood of a SVR depends on various host and viral factors, as sex, stage of liver fibrosis, HCV genotype and viral kinetics during treatment, being the rapid virologic response (RVR; undetectable HCV-RNA in serum after 4 weeks of therapy) a strong predictor of SVR. Recently, it has been reported that a single-nucleotide polymorphism (SNP) near the IL28B gene, named rs12979860, is a predictor of response to therapy in non-hemophiliacs. This SNP may be genotyped as CC, CT or TT and the CC variant has been associated with higher rates of SVR and with higher rates of spontaneous viral clearance after acute infection. Methods and Results: the SNP was determined by Polymerase Chain Reaction in 189 patients with hemophilia aged 37–54 years (median: 44) infected with HCV. Fifty-five patients (29%) were HIV and 10 (5%) HBV co-infected. HCV genotype 1 was the most prevalent (n=124, 73%) and the IL28B SNP was CC in 70 (37%), CT in 104 (55%) and TT in 15 (8%). The median duration of HCV infection was 34 years (IQR: 28–39) and the median age at antiviral treatment 38 years (IQR: 31–46). Clinical signs of cirrhosis were present in 22 patients (12%). Fifteen patients (8%) had spontaneous clearance of viral infection and 134 (71%) of those with chronic infection underwent antiviral therapy that was Peg-IFN plus ribavirin in 114 (85%). Overall SVR rate was 49% (37% in patients with HCV genotype 1 and 70% in those with HCV genotype 2 or 3). Rapid, early and sustained virologic response were more frequent in patients carrying the CC SNP than in those carrying a non-CC SNP (59 vs 17%, 90 vs 71% and 67 vs 39%, respectively; p<0.05). By stratifying patients by HCV genotype, the presence of the CC variant was associated with higher RVR rate in patients with HCV type 1 (40 vs 9%; p<0.01), while no difference was observed in patients with HCV type 2 or 3. By univariate logistic regression HCV genotype 2 or 3, the CC IL28B SNP, the absence of cirrhosis and RVR were predictors of SVR (Odds Ratio 4.0, 3.1, 4.5 and 10.2, respectively). By multivariate analysis, only RVR was confirmed as independent predictor of SVR (Adjusted Odds Ratio 7.2; 95%CI 2.2–23.8). Moreover, the presence of the CC IL28B SNP was more prevalent among patients who had a spontaneous clearance of HCV infection (60% vs 35% in those who have chronic hepatitis C). Conclusions: The IL28B SNP may serve as pre-treatment predictor of IFN-based therapies outcome in patients with hemophilia and chronic hepatitis C, since the CC variant is associated with a higher chance of SVR. Our data also confirm that on-treatment viral kinetics has a key role and a stronger impact on the final outcome, since the achievement of RVR was the only independent predictor of SVR. However, due to the higher chances of SVR, the presence of a CC IL28B SNP should encourage the attempt at eradicating HCV infection in patients with genotype 1 by using the standard of care instead of waiting for new antiviral drugs that may increase therapy-related side effects. Disclosures: No relevant conflicts of interest to declare.

Solving the gap between HCV detection and treatment in prison. HCV-RNA testing and treatment in a cohort of new arriving convicts in Southern Italy

2021 ◽  
Vol 16 ◽  
Author(s):  
Carmine Izzo ◽  
Mario Masarone ◽  
Pietro Torre ◽  
Giuseppe Melara ◽  
Giuseppe De Matteis ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Southern Italy ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Blood Capillary ◽  
Test And Treat ◽  
Number Of Patients ◽  
Lost To Follow Up ◽  
Incident Cases

Introduction: HCV infection elimination is set to be carried out by 2030. To achieve this goal, the WHO has set minor achievable short-term “mini-goals.” One of these is the treatment of “difficult to reach and treat populations,” such as prisoners. One of the biggest obstacles to reaching this mini goal is the poor knowledge of the real HCV prevalence in such a population and the barriers to its detection, treatment, and follow-up. Even if HCV testing in Italian prisons is feasible and recommended, it is not always carried out. To worsen the picture, the peculiar status of conviction is correlated with the difficulty in carrying out the antiviral therapy due to challenges in follow-up and the refusals by inmates. Aims: A point-of-care test-and-treat program was set up in a penitentiary in Southern Italy to reduce the number of patients lost-to-follow-up (LTFU) between detection and treatment. A secondary aim was to evaluate the prevalence of HCV-infected patients in a cohort of new inmates. Methods: This prospective-observational study was carried out from January 2020 to February 2020. We performed a quick HCV-RNA blood capillary test on all new arriving inmates. As a routine, the new inmates underwent clinical and laboratory assessments. To those who were detected as HCV-RNA positive, the shortest possible antiviral treatment was offered, according to genotype and clinical features. Results: We observed 122 new inmates in the period between January and February of 2020. Overall, 62 (50.8%) subjects accepted HCV-RNA quick testing through blood sampling. Four (6.4%) subjects were found to be HCV-RNA positive; 1 refused antiviral therapy while 3 accepted, obtaining 100% SVR. None of the HCV-active inmates were lost-to-follow-up between detection and treatment proposal. Conclusion: The use of a very fast test-and-treat protocol for HCV infection demonstrated to be effective to avoid LTFU in HCV-positive new inmates in the period between detection and treatment. We observed an apparent prevalence of HCV incident cases in newly arriving inmates of 6.4%. Antiviral therapy was quickly provided, secure, and successful.

scholarly journals 1069. Loss to follow-up does not impact SVR for HCV infection

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S563-S563
Author(s):  
Sita K Kottilil ◽  
Mrunal Kamat ◽  
Amit Gupte ◽  
Samir Shah
Keyword(s):  
Hepatitis C ◽  
Previous Treatment ◽  
Virologic Response ◽  
Post Treatment ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Duration Of Treatment ◽  
Group A ◽  
Group B

Abstract Background Recent advances in hepatitis C treatment using direct acting antiviral (DAA) agents can lead to sustained virologic response (SVR) in almost all treated subjects. These data along with the availability of generic DAAs have generated optimism to eliminate HCV infection globally. However, recent pilot projects aimed at HCV elimination have resulted in disappointing SVR due to lack of follow up of patients after they complete treatment. In this study, we evaluated the SVR among those who did not follow up for the 12 week post treatment visit versus that of those who did, Aim – To determine SVR among those who follow up compared to those who have delayed follow up to assess SVR. Table Methods 226 patients who underwent treatment for hepatitis C in a subspecialty clinic in Mumbai, India between 2014-16, with complete laboratory and clinical data available were included in this analysis. All patients completed 12 weeks of treatment with an approved DAA regimen. 137 patients had adequate follow up post treatment for SVR (Group A) and 89 patients were “no shows” for SVR (Group B) and had to be actively followed to obtain HCV RNA levels at least 4 weeks after SVR visit. Graph Pad prizm and student t test were used to determine the difference between SVR among the two groups. Results Demographics of both groups of patients are shown in the table below. SVR for the patients with good follow up (Group A) was 97.1% (133/137) and that of patients with poor follow up (Group B) was 97.8% (87/89), which was not statistically different (p &gt;0.05). There were no baseline demographics that was associated with poor follow up, including age, gender, genotype, baseline fibrosis score, ALT levels, previous treatment status, or duration of treatment (P &gt;0.05) Conclusion Lack of follow up after completion of treatment with DAAs is associated with identical SVR compared to those with adequate follow up. These findings suggest lack of follow up after completion of treatment should have minimal effect on HCV elimination projects. In the future, HCV elimination projects need not focus on determination of SVR as long as treatment follow up is ensured Disclosures All Authors: No reported disclosures

Lack of Hcv Infection in Malignant, Cells Refutes the Hypothesis of a Direct Transforming Action of the Virus in the Pathogenesis of Hcv-Associated B-Cell Nhls

2002 ◽  
Vol 88 (5) ◽  
pp. 400-406 ◽  
Author(s):  
Salvatore De Vita ◽  
Valli De Re ◽  
Domenico Sansonno ◽  
Annunziata Gloghini ◽  
Daniela Gasparotto ◽  
...  
Keyword(s):  
B Cells ◽  
B Cell ◽  
Hcv Infection ◽  
Low Grade ◽  
Immunoglobulin Gene ◽  
Pathogenetic Role ◽  
Exogenous Trigger ◽  
Grade One ◽  
Hodgkin's Lymphomas

Aims and background Preliminary evidence suggests that hepatitis C virus (HCV) might play a pathogenetic role in autoimmune-related, non-malignant B-cell lymphoproliferation, as well as in a subset of B-cell non-Hodgkin's lymphomas (NHLs). With regard to the mechanism(s) by which HCV might favor B-cell expansion and malignant transformation, most data support an indirect pathogenetic role of the virus as an exogenous trigger. A direct oncogenetic role of HCV by direct cell infection and deregulation has only been hypothesized on the basis of the lymphotropism of the virus. Methods In this study we investigated the possible HCV infection of NHL B cells by means of sensitive and quantitative polymerase chain reaction (PCR) on affinity-purified neoplastic cells, and by HCV-specific immunohistochemistry and in situ hybridization. Results HCV infection of neoplastic B cells was documented in only three cases, namely the low-grade B-cell NHLs that arose in the course of mixed cryoglobulinemia syndrome (MC). HCV infection, below one viral genome per cell, was detectable only by PCR. All the remaining low-grade (one case) and high-grade B-cell NHLs (two cases) were HCV uninfected. Previous immunoglobulin gene analyses were consistent with an antigen-driven B-cell lymphoproliferation in the studied cases. Conclusions Overall, our data are consistent with an indirect oncogenetic role of HCV in B-cell lymphomagenesis as an exogenous trigger. Infection of B cells by HCV appears possible in some NHL subsets, but the implications remain unknown.

scholarly journals 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 ◽  
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&lt;.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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