scholarly journals Recurrence of hepatitis C virus after treatment with pegylated interferon and direct acting antivirals in Punjab Pakistan

2023 ◽  
Vol 83 ◽  
Author(s):  
M. N. Raza ◽  
K. Sughra ◽  
N. Zeeshan ◽  
M. Z. Anwar ◽  
M. A. Shahzad ◽  
...  

Abstract Although increased response rates concomitant in hepatitis C virus but relapse after treatment is threatened. Therefore, it is terrible requirement to evaluate the response of Pegylated interferon and direct acting antivirals in Punjab Pakistan. The study was conducted to find the rate of recurrence of HCV infection after treatment with Pegylated Interferon and Direct Acting Antivirals in Punjab Pakistan. This study was conducted at Department of Pathology, Nawaz Sharif Medical College Gujrat, while treatment effects monitored in different Government and Private Hospitals of Punjab, Pakistan. Total 973 patients who administered the recommended dose and divided in two groups (i) Interferon based therapy (ii) direct acting antivirals (DAAs).Other parameters like ALT and viral load studied. The rate of recurrence was higher in female infected with genotype 2b and in male with mixed genotype 3a/2b after six month of antiviral therapy. Genotype 3a showed significant response to therapy after three month. 32 among 374 (8.5%) were positive after 24 weeks of treatment with interferon, 29 (7.7%) patients have same genotype while 3 patients were re-infected with different HCV strains. With DAAs, only 27 (4.8%) patients were positive among 558 after 2 weeks and one patient re-infected with different genotype. Early and sustained virological response noted in DAAs. ALT and viral load decreased faster with DAAs that not achieved after 4 weeks with pegylated interferon. Sustained virological response appears in DAAs and recurrence rate is high in interferon therapy compared to DAAs. Therefore, reinfection has implications for correct treatment efficiency and to select strategies for retreatment cases.

2013 ◽  
Vol 94 (6) ◽  
pp. 1259-1265 ◽  
Author(s):  
Cristina Bucci ◽  
Annette von Delft ◽  
Annabel Christian ◽  
Vicki M. Flemming ◽  
Abby Harrison ◽  
...  

IL28B host genetic make-up is known to play a critical role in the outcome of genotype 1 hepatitis C virus (HCV) infection in the context of both primary infection and therapy. However, the role of IL28B in subtype 3a infection remains unclear, and has not yet been assessed in the UK population where subtype 3a is dominant. In this study, we evaluated the role of the IL28B single-nucleotide polymorphism rs8099917 in 201 patients recruited from two well-defined cohorts (from Nottingham and Oxford), treated with the standard-of-care therapy of pegylated interferon and ribavirin for 24 weeks. We showed that the ‘favourable’ IL28B gene was associated with a rapid virological response to therapy at 4 weeks (P<0.0001), but not with a sustained virological response to therapy. The median viral load at baseline, before therapy, was markedly increased in people with the ‘favourable’ IL28B genotype [median viral load for the TT allele, 925 961 IU ml−1 (range 2200–21 116 965 IU ml−1), and for the GT or GG allele, 260 284 IU ml−1 (range 740–7 560 000 IU ml−1); P = 0.0010]. Our results suggest that the host genetic response plays an important role in early viral clearance of subtype 3a virus from the blood. However, significant reservoirs of infection must persist, as viral relapse is common, even in those with the favourable host genotype.


2015 ◽  
Vol 9 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Tatsuo Kanda ◽  
Masato Nakamura ◽  
Reina Sasaki ◽  
Shin Yasui ◽  
Shingo Nakamoto ◽  
...  

Direct-acting antivirals with or without peginterferon α (PEG-IFN α) plus ribavirin are now available for the treatment of hepatitis C virus (HCV) infection. Direct-acting antivirals are potent inhibitors of HCV replication, but some of them occasionally possess serious adverse events. We experienced a 64-year-old female with chronic HCV genotype 1b infection who showed elevated alanine aminotransferase of 528 IU/l at week 9 after the commencement of treatment of simeprevir with PEG-IFN α-2a plus ribavirin. However, she achieved sustained virological response at week 24 after the end of treatment. In Japan, we also have to treat elderly patients infected with HCV and/or advanced hepatic fibrosis. Until an effective interferon-free regimen is established, direct-acting antivirals with PEG-IFN plus ribavirin may still play a role in the treatment for certain patients. To avoid serious results from adverse events, careful attention and follow-up will be needed in the treatment course of simeprevir with PEG-IFN plus ribavirin for chronic HCV infection.


2020 ◽  
Author(s):  
Muhammad Naeem Raza ◽  
Kalsoom Sughra ◽  
Nadia Zeeshan

Abstract Background Although increased response rates concomitant in hepatitis C virus but relapse after treatment is threatened. Therefore, it is terrible requirement to evaluate the response of Pegylated interferon and direct acting antivirals in Pakistan.Methods This study conducted at Department of Pathology, Nawaz Sharif Medical College Gujrat, while treatment effects monitored in different Government and Private Hospitals of Punjab, Pakistan from July 2017 to January 2019. Total 973 patients administered the recommended dose that divided in two groups (i) Interferon based therapy (ii) direct acting antivirals (DAAs).Other parameters like ALT and viral load studied.Results The 374 patients given interferon therapy and 32 of 374 were positive after 24 weeks of treatment. Among these 29 patients have same genotype and recurrence was present .While 3 patients were re-infected with different HCV strains. In case of DAAs, only 27 patients were positive among 558 patients after 2 weeks and only one patient re-infected with different genotype. Early and sustained virologic response noted in DAAs. ALT and viral load decreased faster with DAAs that not achieved after 4 weeks with pegylated interferon.Conclusion SVR appears in DAAs and recurrence rate was high in interferon-based therapy as compared to DAAs. Therefore, reinfection has implications for correct treatment efficiency and to select optimal strategies for retreatment cases.


2016 ◽  
Vol 17 (1) ◽  
pp. 9-14
Author(s):  
Vuk R. Vukovic ◽  
Dejan Baskic ◽  
Zeljko Mijailovic ◽  
Predrag Djurdjevic

Abstract Treatment of patients suffering from chronic hepatitis C with standard pegylated interferon alpha 2a plus ribavirin has limited efficacy. Therapy outcome is dependent on several factors of both the host and virus, including age, sex, stage of fibrosis, viral genotype, viral load, and occurrence of haematological adverse events during chronic hepatitis C treatment. The aim of this study was to determine the relationship between the viral and host factors and the haematological side effects of therapy with sustained virological response. Fifty-four patients were treated with combined pegylated interferon alpha 2a plus ribavirin therapy. Hepatitis C virus genotyping, viral load, histopathological liver changes and biochemical parameters were evaluated for each patient before beginning treatment. Each patient’s blood count was analysed during each clinical visit. Sustained virological response was achieved in 75,9% of patients. Baseline AST and ALT levels were significantly higher in patients with a poor response to therapy (p<0,05). Other clinical and laboratory parameters did not reach statistical significance. Both responders and non-responders developed anaemia. A decrease in thrombocytes, neutrophils and white blood cells was significantly associated with a sustained response to therapy (p<0,05, p<0,05 and p<0,001, respectively). Sustained virological response was associated with lower baseline AST and ALT values and thrombocytopenia, leucopenia and neutropenia at the end of the treatment. All treated patients developed anaemia.


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