Sustained Viral Response with Direct-Acting Antivirals in Patients with Recurrent Hepatitis C with Genotype 1 After Liver Transplant: A Single-Center Experience

2016 ◽  
Vol 111 ◽  
pp. S377-S378
Author(s):  
Jiten P. Kothadia ◽  
Hrishikesh Samant ◽  
Saurabh Kapur ◽  
Robyn Rudloff ◽  
Rinjal Brahmbhatt ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Sustained Viral Response ◽  
Genotype 1 ◽  
Direct Acting Antivirals ◽  
Single Center ◽  
Viral Response ◽  
Recurrent Hepatitis ◽  
Single Center Experience ◽  
Recurrent Hepatitis C ◽  
Direct Acting

Hepatocellular Carcinoma Occurrence/Recurrence after Direct-Acting Antivirals for Hepatitis C in Egyptian Cohort: Single-Center Experience

2019 ◽  
Vol 37 (6) ◽  
pp. 488-497
Author(s):  
Sameh A. Lashen ◽  
Mohammed M. Shamseya ◽  
Marwa A. Madkour
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
De Novo ◽  
Independent Predictor ◽  
Alpha Fetoprotein ◽  
Direct Acting Antivirals ◽  
Single Center ◽  
Single Center Experience ◽  
Direct Acting ◽  
Hcc Recurrence

Background: Conflicting data have been published about the risk of hepatocellular carcinoma (HCC) following direct-acting antivirals (DAAs). We investigated the incidence of HCC occurrence/recurrence after DAAs therapy. Patients and Methods: Retrospectively, we analyzed data of 392 patients with F3–4 fibrosis and cirrhosis treated by DAAs during the period from August 2015 to May 2018. In HCC-experienced patients, HCC treatment modality, and the duration between HCC management and DAAs initiation were recorded. In all patients, pretreatment clinicolaboratory evaluation, and imaging before, during and after DAAs were done. Results: De novo HCC occurred in 7.6% of naïve patients, while recurrence appeared in 28% of patients with previous HCC. Pretreatment alpha-fetoprotein was an independent predictor of HCC occurrence, while the time between HCC ablation and the beginning of DAAs was the only predictor of HCC recurrence (p < 0.001). Half of the patients who started DAAs before 6 months had HCC recurrence, while patients who started DAAs at ≥6 months had no recurrence (p< 0.0001). Conclusions: Although HCC occurrence after DAAs was not high, recurrence was apparently high. Pretreatment alpha-fetoprotein is a predictor for de novo HCC. The time between HCC ablation and DAAs was the strongest predictor of recurrence.

Impact of direct-acting antivirals and 12-week sustained viral response on clinical outcomes in patients with hepatitis C and hepatocellular carcinoma.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 397-397
Author(s):  
William M Kamp ◽  
Cortlandt Sellers ◽  
Stacey Stein ◽  
Joseph K Lim ◽  
Hyun S. Kevin Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Hepatitis C ◽  
Sustained Viral Response ◽  
Tumor Location ◽  
Care Hospital ◽  
Direct Acting Antivirals ◽  
Treatment Allocation ◽  
Viral Response ◽  
Direct Acting

397 Background: To investigate the impact of direct-acting antivirals (DAA) and 12-week sustained viral response (SVR12) in patients with hepatocellular carcinoma (HCC) and hepatitis C viral infections (HCV). Methods: Retrospective analysis of HCC patients diagnosed from 2005 to 2016 at an urban tertiary-care hospital. Kaplan-Meier curves and multivariable Cox proportional hazards models were used to assess survival. Results: Nine hundred ninety-six patients met inclusion criteria (mean age 62.8±10.2 yrs, 79% male). Four hundred seventy-eight (50%) patients received interventional oncology (catheter-based therapies, ablation and combination locoregional therapies), 141 (15%) received supportive care (palliative or no treatment), 125 (13%) received a transplant, 112 (14%) had tumor resection and 94 (12%) received chemotherapy or radiation as their primary treatment. Median overall survival (OS) of the entire cohort was 24.2 months (95% CI: 20.9-27.9). Transplant patients were excluded from further analysis. Four hundred seventy patients had HCV (56%). One hundred twenty-three patients received one or more DAA therapies for HCV (26.2%), 83 of whom achieved SVR12 (68%). HCC occurrence and recurrence were reported in 29 (26%) and 38 (45%) patients, respectively, after DAA therapy. HCV-positive and HCV-negative patients had similar survival (OS 20.7 mo vs 17.4 mo, p=0.22). Patients receiving DAA therapy had a higher OS of 71.8 mo (CI: 39.5-not reached) vs 11.6 mo (CI: 9.8-14.5) for patients without DAA therapy (p<0.0001). DAA patients who achieved SVR12 had a higher OS of 75.6 mo (CI: 49.2-not reached) vs the non-SVR12 group (26.7 mo, CI: 13.7-31.1, p<0.0001). Multivariable analysis (MVA) showed that AJCC, Child-Pugh Score, MELD, tumor size, tumor location and treatment allocation had independent influence on survival for the cohort (p<0.05). In HCV patients, AJCC, MELD, tumor location, treatment allocation and DAA were significant (p<0.05). In patients receiving DAA, only MELD score and SVR12 remained significant factors (p<0.05). Conclusions: DAA therapy and achieving SVR12 is associated with increased overall survival in HCC patients with HCV. This analysis supports the importance of treating HCV to SVR12 as part of HCC management.

scholarly journals Korszakváltás a krónikus C-vírus hepatitis terápiájában – új direkt ható antivirális szerek

2015 ◽  
Vol 156 (21) ◽  
pp. 841-848
Author(s):  
Gábor Horváth ◽  
Tünde Halász ◽  
Mihály Makara ◽  
Béla Hunyady
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Sustained Viral Response ◽  
Virus Hepatitis ◽  
Direct Acting Antivirals ◽  
Screening Programs ◽  
Viral Response ◽  
Direct Acting

Chronic hepatitis C, without treatment, can cause liver cirrhosis, liver failure and liver cancer. The availability of new oral direct acting antivirals, such as the protease inhibitors simeprevir, asunaprevir and paritaprevir, the NS5A inhibitors daclatasvir, ledipasvir, and ombitasvir, the polymerase inhibitors Sofosbuvir and dasabuvir have resulted an enormous progress in the treatment of chronic hepatitis C, leading to >90% sustained viral response rates. Even the hard-to-treat or previously treatment ineligible patients can be cured with the combination of these drugs. Furthermore the treatment duration is much shorter, and the side effects are minimal. Today, treatment of all hepatitis C virus infected patients is recommended, and the best choices are the interferon-free options. Eradication of hepatitis C virus has become realistic, however, appropriate screening programs are mandatory to achieve this goal. Orv. Hetil., 2015, 156(21), 841–848.

Sign in / Sign up

Export Citation Format

Share Document