scholarly journals Excellent Completion Rate of 8-Weeks Hepatitis C Treatment in Prison; Results of French National Study.

2019 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Jean-Marie RUIZ ◽  
Philippe ALARCON ◽  
Chloé GOBIN ◽  
Jean-Claude GUICHARD ◽  
Aurore BARON
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Multicenter Trial ◽  
Completion Rate ◽  
National Study ◽  
Genotype 1 ◽  
Viral Hepatitis C ◽  
Prison Environment ◽  
The Impact

Rationale Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Prevalence of viral hepatitis C (HCV) is higher in prison environment in France than in the general population and is estimated to be 4,8%. The impact in prison environment is little-known as based on local studies. Inmate health care falls under USMP (prison setting medical unit), hospital specific units as by the january 18, 1994 law. Access to antiviral c treatment for inmates has always been difficult in France, would it be for interferon and ribavirin or use of protease inhibitors, with less than 20% of treated patients. French recommendations for HCV screening recommend systematic screening of inmates. The arrival of all oral therapies by direct antiviral agents (DAA) with shorter treatment times was an opportunity for doctors to propose a treatment and the patient to accept it. In 2014, the French guidelines recommended that HCV carriers in prison should systematically be treated independently of the stage of fibrosis. Objective of the Study PH8 Our objective was to evaluate the completion rate of an 8-week antiviral C treatment by sofosbuvir / ledipasvir regimen in non-cirrhotic genotype 1 patients in deprivation of liberty and achieve sustained virological response (SVR) and to measure the effectiveness of an 8-week treatment (by protocol analysis). Methodology prospective non-interventional multicenter trial among inmates with chronic hepatitis C genotype 1 with METAVIR fibrosis score F0 to F2 and who will receive a daily combination of sofosbuvir / ledipasvir for 8 weeks. Results 6 prison medical units included 115 consenting patients: there were 81% men, mean age 41 years (21 to 64 years). Route contamination was drug injection for 85%. HCV genotype was 1a for 74%, 1b for 24% and 2% none differenciated 1. Fibroscan mesure was available in 89 patients (mean score 3,5 KPa). Fibrotest was available in 37 patients with mean value 0.21. Eleven patients had Fibroscan and Fibrotest; 69% of patients were F0, 22% F1 and 9% F2. Average time between diagnosis and start of treatment was 3 weeks. We are sure that 109 patients (95%) completed DAA 8 weeks treatment; only 2 stopped DAA treatment before 8 weeks and 4 had no follow up after end of detention. HCV viral load was measured at W2 for 90 patients (78%), at W4 for 92 patients (78%), at end of treatment for 92 patients (78%), one month after treatment for 90 patients (78%) and 3 months after for 95 patients (93%). Only one viral load was positive, one month after treatment. Patient was retreated by sofosbuvir / velpastasvir. All HCV viral load 3 months after treatment negative; one patient took DAA only 6 weeks was cured. Conclusions In these study PH8, we observed completion rate of 94% for included patients in patient with 8 weeks ledipasvir/sofosbuvir regimen; data missed for only 4 patients and one relapsed. Short DAA treatment was efficient in prisoners and could be preferred in specific population.

scholarly journals Impact of Hepatitis B Exposure on Sustained Virological Response Rates of Highly Viremic Chronic Hepatitis C Patients

2009 ◽  
Vol 2009 ◽  
pp. 1-5
Author(s):  
Ioannis S. Elefsiniotis ◽  
Christos Pavlidis ◽  
Elena Vezali ◽  
Theodoros Mariolis-Sapsakos ◽  
Sotirios Koutsounas ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Viral Load ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Genotype 1 ◽  
Treatment Naïve ◽  
The Impact

Aim. To evaluate the impact of hepatitis B core antibody (anti-HBc) seropositivity in sustained virological response (SVR) rates in treatment-naïve, chronic hepatitis C (CHC) patients with high pretreatment viral load (>800000 IU/mL).Methods. 185 consecutive CHC patients (14.4% cirrhotics, 70.2% prior intravenous drug users) treated with pegylated interferon-a2b plus ribavirin, for 24 or 48 weeks based on viral genotype, were retrospectively analyzed. SVR was confirmed by undetectable serum HCV-RNA six months after the end of treatment schedule.Results. Thirty percent of CHC/HBsAg-negative patients were anti-HBc-positive. Anti-HBc positivity was more prevalent in cirrhotic, compared to noncirrhotic patients (76.9% versus 19.5%,P<.05). Serum HBV-DNA was detected in the minority of anti-HBc-positive patients (1.97%). Overall, 62.1% of patients exhibited SVR, while 28.6% did not; 71.4% of non-SVRs were infected with genotype 1. In the univariate analysis, the anti-HBc positivity was negatively associated with treatment outcome (P=.065). In the multivariate model, only the advanced stage of liver disease (P=.015) and genotype-1 HCV infection (P=.003), but not anti-HBc-status (P=.726), proved to be independent predictors of non-SVR.Conclusion. Serum anti-HBc positivity does not affect the SVR rates in treatment-naïve CHC patients with high pretreatment viral load, receiving the currently approved combination treatment.

Hemostatic disorders and their clinical and pathogenetic significance in children with chronic viral hepatitis C

2019 ◽  
Author(s):  
Е.Ю. Коновалова ◽  
А.Е. Лаврова ◽  
М.В. Преснякова
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Platelet Aggregation ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Hepatic Diseases ◽  
Viral Hepatitis C ◽  
Aggregation Activity ◽  
The Impact ◽  
Chronic Viral Hepatitis C

Введение. В последние годы отмечается рост заболеваний печени у детей, среди которых одно из ведущих мест занимает хронический вирусный гепатит С (ХГС). Однако до настоящего времени окончательно не изучено воздействие вируса на организм ребенка, а именно, влияние вируса на гемостазиологический гомеостаз. Цель исследования: изучить нарушения системы гемостаза и оценить их клиникопатогенетическое значение у детей с ХГС. Материалы и методы. В исследование включен 31 пациент с ХГС в возрасте от 3 до 17 лет 17 (55) девочек и 14 (45) мальчиков. Контрольную группу составили 15 детей, относящихся к I или II группам здоровьям. У всех участников исследования оценивали состояние эндотелия, системы гемокоагуляции, эндогенных антикоагулянтов и фибринолиза, агрегационную активность тромбоцитов. Результаты. У детей с ХГС в первые 10 лет заболевания, несмотря на высокий уровень виремии, отсутствовали признаки тяжелого поражения печени. Изменения в системе гемостаза проявлялись повышением агрегационной активности тромбоцитов, фактора фон Виллебранда, содержания эндотелина1 и гомоцистеина, активности антитромбина III и ингибито ра активатора плазминогена. Увеличение вирусной нагрузки при ХГС у детей сопровождалось нарушением коагуляционного гемостаза. Длительная персистенция вируса в организме ребенка сопровождалась увеличением плотности печени по данным непрямой эластометрии. Заключение. ХГС у детей в первые 10 лет заболевания характеризуется относительно мягким течением. Независимо от генотипа вируса выявляются нарушения, затрагивающие сосудистотромбоцитарное, антикоагулянтное и фибринолитические звенья системы гемостаза, которые коррелируют с тяжестью патологического процесса. Introduction. In recent years the increasing incidence of hepatic diseases is noted in children and chronic viral hepatitis C (CHC) occupies among them one of the leading places. However, until now the impact of this virus on the childs organism has not been properly studied yet, in particular the virus effect on hemostasiological homeostasis. Aim: to study haemostatic disorders and to assess their clinical and pathogenetic significance in children suffering from CHC. Materials and methods. The study included 31 patients with CHC aged from 3 to 17 years 17 (55) girls and 14 (45) boys. The control group consisted of 15 children with their health category I and II. The state of endothelium, haemocoagulation system, endogenous anticoagulants and fibrinolysis and the platelet aggregation activity were assessed in all patients. The increase in viral load in children with CHC was accompanied by disturbance of coagulation hemostasis. Prolonged persistence of the virus in the childs body was accompanied by an increase in liver density according to indirect elastometry. Results. In the first 10 years of the disease children with CHC had no symptoms of severe hepatic lesion in spite of high viremia level. Haemostatic changes were manifested by increased platelet aggregation activity, von Willebrand factor, endothelin1 and homocysteine levels, antitrombine III activity and plasminogen activator inhibitor. The increased viral load in children with CHC was followed by disturbance of coagulation hemostasis. Prolonged virus persistence in the childs body was accompanied by higher hepatic density according to indirect liver elastometry data. Conclusion. In the first 10 years of the disease CHC in children is characterized by a relatively mild course. Irrespective of viral genotype disorders are identified affecting vascularplatelet, anticoagulative and fibrinolytic links of hemostasis that correlate with the pathologic process severity.

scholarly journals Telemedicine Chronic Viral Hepatitis C Treatment during the Lockdown Period in Romania: A Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3694
Author(s):  
Irina Paula Doica ◽  
Dan Nicolae Florescu ◽  
Carmen Nicoleta Oancea ◽  
Adina Turcu-Stiolica ◽  
Mihaela-Simona Subtirelu ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Pilot Study ◽  
Multidisciplinary Approach ◽  
Therapy Monitoring ◽  
Antiviral Agents ◽  
Item Score ◽  
Hcv Therapy ◽  
Viral Hepatitis C ◽  
Significant Difference

The COVID-19 pandemic is currently delaying the process of chronic hepatitis C (HCV) eradication, since most of the chronic diseases are neglected. Thus, there is a need for alternative programs for HCV therapy implementation and disease monitoring. Our aim was to provide a multidisciplinary approach, so that HCV-infected patients from distant locations may benefit from HCV antivirals during the COVID-19 outbreak and within the lockdown period in Romania. Previously diagnosed HCV patients willing to participate in this telemedicine pilot study were included. Patient characteristics and medical adherence were assessed and compared to the year preceding the pandemic. We proposed a multidisciplinary approach by using a telemedicine program for HCV therapy monitoring. Patients also received a satisfaction questionnaire after delivering the sustained virologic response (SVR) result. A total of 41 patients agreed to participate in this study. The medication adherence was 100% for patients included in the telemedicine group, with a statistically significant difference from the medication adherence of the patients treated in 2019. The satisfaction item score was 4.92 out of 5 and our results (r = −0.94, p < 0.0001) suggested that older patients embraced the telemedicine program less, but with the same success in terms of SVR (100%) and medication adherence (100%). Our pilot study offers the first example of a telemedicine program in Romania for HCV therapeutic management. During the lockdown period, telemedicine has served as a reliable tool and novel alternative for conventional monitoring of patients treated with direct antiviral agents and should be further considered even following the pandemic.

scholarly journals Virological Factors Associated with Failure to the Latest Generation of Direct Acting Agents (DAA) and Re-Treatment Strategy: A Narrative Review

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 432
Author(s):  
Lorenzo Onorato ◽  
Mariantonietta Pisaturo ◽  
Mario Starace ◽  
Carmine Minichini ◽  
Alessandra Di Fraia ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Clinical Problem ◽  
Narrative Review ◽  
Factors Associated ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
The Impact ◽  
Direct Acting Antiviral Agents

The availability of all oral direct acting antiviral agents (DAAs) has revolutionized the management of HCV infections in recent years, allowing to achieve a sustained virological response (SVR) in more than 95% of cases, irrespective of hepatitis C Virus (HCV) genotype or staging of liver disease. Although rare, the failure to the latest-generation regimens (grazoprevir/elbasvir, sofosbuvir/velpatasvir, pibrentasvir/glecaprevir) represents a serious clinical problem, since the data available in the literature on the virological characteristics and management of these patients are few. The aim of the present narrative review was to provide an overview of the impact of baseline RASs in patients treated with the latest-generation DAAs and to analyze the efficacy of the available retreatment strategies in those who have failed these regimens.

scholarly journals Hepatitis C Virus Deletion Mutants Are Found in Individuals Chronically Infected with Genotype 1 Hepatitis C Virus in Association with Age, High Viral Load and Liver Inflammatory Activity

PLoS ONE ◽  
2015 ◽  
Vol 10 (9) ◽  
pp. e0138546 ◽  
Author(s):  
Cristina Cheroni ◽  
Lorena Donnici ◽  
Alessio Aghemo ◽  
Francesca Balistreri ◽  
Annalisa Bianco ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Viral Load ◽  
Hepatitis C ◽  
High Viral Load ◽  
Inflammatory Activity ◽  
Deletion Mutants ◽  
Genotype 1

scholarly journals Naturally Occurring Resistance-Associated Variants of Hepatitis C Virus Protease Inhibitors in Poor Responders to Pegylated Interferon-Ribavirin

2015 ◽  
Vol 53 (7) ◽  
pp. 2195-2202 ◽  
Author(s):  
Sylvie Larrat ◽  
Sophie Vallet ◽  
Sandra David-Tchouda ◽  
Alban Caporossi ◽  
Jennifer Margier ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Viral Load ◽  
Hepatitis C ◽  
Triple Therapy ◽  
Pegylated Interferon ◽  
Poor Responders ◽  
Obvious Effect ◽  
Treatment Naïve ◽  
Detection Of Mutations ◽  
The Impact

The pretherapeutic presence of protease inhibitor (PI) resistance-associated variants (RAVs) has not been shown to be predictive of triple-therapy outcomes in treatment-naive patients. However, they may influence the outcome in patients with less effective pegylated interferon (pegIFN)-ribavirin (RBV) backbones. Using hepatitis C virus (HCV) population sequence analysis, we retrospectively investigated the prevalence of baseline nonstructural 3 (NS3) RAVs in a multicenter cohort of poor IFN-RBV responders (i.e., prior null responders or patients with a viral load decrease of <1 log IU/ml during the pegIFN-RBV lead-in phase). The impact of the presence of these RAVs on the outcome of triple therapy was studied. Among 282 patients, the prevalances (95% confidence intervals) of baseline RAVs ranged from 5.7% (3.3% to 9.0%) to 22.0% (17.3% to 27.3%), depending to the algorithm used. Among mutations conferring a >3-fold shift in 50% inhibitory concentration (IC50) for telaprevir or boceprevir, T54S was the most frequently detected mutation (3.9%), followed by A156T, R155K (0.7%), V36M, and V55A (0.35%). Mutations were more frequently found in patients infected with genotype 1a (7.5 to 23.6%) than 1b (3.3 to 19.8%) (P= 0.03). No other sociodemographic or viroclinical characteristic was significantly associated with a higher prevalence of RAVs. No obvious effect of baseline RAVs on viral load was observed. In this cohort of poor responders to IFN-RBV, no link was found with a sustained virological response to triple therapy, regardless of the algorithm used for the detection of mutations. Based on a cross-study comparison, baseline RAVs are not more frequent in poor IFN-RBV responders than in treatment-naive patients and, even in these difficult-to-treat patients, this study demonstrates no impact on treatment outcome, arguing against resistance analysis prior to treatment.

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