scholarly journals Place of therapeutic patient education in chronic hepatitis C treated with direct-acting antivirals

2022 ◽  
pp. 60
Author(s):  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Patient Education ◽  
Chronic Hepatitis C ◽  
Social Care ◽  
Severe Disease ◽  
Direct Acting Antivirals ◽  
Therapeutic Patient Education ◽  
Direct Acting ◽  
The Impact

Objective: Today, with the availability of direct-acting antivirals (DAAs), the value of therapeutic patient education (TPE) in chronic hepatitis C needs to be redefined, as these drugs have made treatment simple. The study presented here in sought to define what role TPE plays today in hepatitis C management along with what factors are associated with such programs being used. Methods: We included 786 patients mono-infected with hepatitis C virus (HCV) who underwent treatment with DAAs. 284 of whom benefited from a TPE program (36.1%). The characteristics of HCV and how it was treated were compared retrospectively between TPE+ and TPE- patients. The TPE program was overseen by a nurse. Results: The following factors were associated with TPE on multivariate analysis: migrant status (OR=3.63, 95%CI: 2.24-5.96, p <0.001), advanced fibrosis (OR=1.73, 95%CI: 1.08-2.76, p=0.022), tobacco use (OR=1.84, 95%CI: 1.10-3.08, p=0.020) and pangenotypic DAA treatment (OR=0.42, 95%CI: 0.26-0.68, p <0.001). Sustained virological response at 12 weeks (SVR 12) was 96% in both groups. Conclusion: Overall, TPE was primarily followed by migrants during their HCV management as part of overall medico-psycho-social care, and primarily those with severe disease. Practice implication: TPE could help reduce the impact of social inequality on health.

scholarly journals The impact of achieving a sustained virological response with direct-acting antivirals on serum autotaxin levels in chronic hepatitis C patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shereen Abou Bakr Saleh ◽  
Khaled Mohamed Abdelwahab ◽  
Asmaa Mady Mady ◽  
Ghada Abdelrahman Mohamed
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Hepatic Fibrosis ◽  
Virological Response ◽  
Direct Acting Antivirals ◽  
Fibrosis Regression ◽  
Direct Acting ◽  
The Impact

Abstract Background Autotaxin (ATX) is an emerging biomarker for liver fibrosis. Achievement of sustained virological response (SVR) by direct-acting antivirals (DAAs) results in hepatic fibrosis regression in chronic hepatitis C (CHC) patients. In this context, the clinical implications of ATX have not yet been well-defined. In this study, we aimed to assess the impact of achieving SVR with DAA therapy on serum ATX levels and whether these levels can reflect the regression of hepatic fibrosis in CHC patients. We evaluated serum ATX levels at baseline and 12 weeks post-DAA therapy in 48 CHC patients. We compared ATX with FIB4 score and AST-to-Platelet Ratio Index (APRI) as regards the detection of grade F3–4 fibrosis. Results Serum ATX levels were significantly declined in 47 patients after the achievement of SVR12 (p < 0.001). The diagnostic ability of ATX for the detection of grade F3–4 fibrosis was inferior to FIB4 and APRI scores at baseline and SVR12. Conclusion Achievement of SVR with DAA therapy causes a significant decline in serum autotaxin concentrations, suggesting early regression of hepatic fibrosis in CHC patients. However, its diagnostic capability for routine patient monitoring and follow-up is still under debate.

scholarly journals Impact of Direct Acting Antivirals on Survival in Patients with Chronic Hepatitis C and Hepatocellular Carcinoma

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
William M. Kamp ◽  
Cortlandt M. Sellers ◽  
Stacey Stein ◽  
Joseph K. Lim ◽  
Hyun S. Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Care Hospital ◽  
Direct Acting Antivirals ◽  
Treatment Type ◽  
Direct Acting ◽  
The Impact

AbstractWith the increasing use of direct-acting antivirals (DAA) for treatment of chronic hepatitis C virus (HCV) infection, we looked at the impact of DAA use and 12-week sustained viral response (SVR12) in patients with hepatocellular carcinoma (HCC) and HCV. This is a retrospective analysis of 969 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. Median overall survival of the cohort was 24.2 months. 470 patients had HCV (56%). 123 patients received DAA therapies for HCV (26.2%), 83 of whom achieved SVR12 (67.4%). HCV-positive and HCV-negative patients had similar survival, 20.7 months vs 17.4 months (p = 0.22). Patients receiving DAA therapy had an overall survival of 71.8 months vs 11.6 months for patients without (p < 0.0001). DAA patients who achieved SVR12 had an overall survival of 75.6 months vs. 26.7 months in the non SVR12 group (p < 0.0001). Multivariable analysis revealed AJCC, Child-Pugh Score, MELD, tumor size, tumor location, cancer treatment type, receiving DAA treatment and achieving SVR12 had independent influence on survival (p < 0.05). This suggests DAA therapy and achieving SVR12 is associated with increased overall survival in HCV patients with HCC.

scholarly journals Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sylvia Drazilova ◽  
Martin Janicko ◽  
Lubomir Skladany ◽  
Pavol Kristian ◽  
Marian Oltman ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Systemic Disease ◽  
Direct Acting Antivirals ◽  
Fasting Glycemia ◽  
End Of Treatment ◽  
History Of ◽  
Direct Acting

Background and Aims. Chronic hepatitis C is a systemic disease and type 2 diabetes mellitus (T2DM) belongs to more common extrahepatic. The aim of this study was to (i) explore the prevalence of impaired fasting glucose (IFG) and T2DM in patients with chronic hepatitis C, (ii) explore the effect of direct acting antivirals (DAA) treatment on the glycemia, and (iii) explore the factors that modulate the effect of DAA treatment on glycemia in patients with chronic hepatitis C.Methods. We performed a longitudinal retrospective observational study focused on the patients undergoing DAA treatment of chronic hepatitis C. Data about glycemia, history of diabetes, hepatitis C virus, treatment, and liver status, including elastography, were obtained at baseline (before treatment start), at the end of treatment and 12 weeks after the end of treatment. Patients were treated with various regimens of direct acting antivirals.Results. We included 370 patients; 45.9% had F4 fibrosis. At baseline, the prevalence of T2DM increased with the degree of fibrosis (F0-F2 14.4%, F3 21.3%, and F4 31.8%, p=0.004). Fasting glycemia also increased with the degree of fibrosis (F0-F2 5.75±0.18 F3 5.84±0.17, and F4 6.69±0.2 mmol/L, p=0.001). We saw significant decrease of glycemia after treatment in all patients, but patients without T2DM or IFG from 6.21±0.12 to 6.08±0.15 mmol/L (p=0.002). The decrease was also visible in treatment experienced patients and patients with Child-Pugh A cirrhosis.Conclusion. We confirmed that the prevalence of either T2DM or IFG increases in chronic hepatitis C patients with the degree of fibrosis. The predictive factors for T2DM were, besides F4, fibrosis also higher age and BMI. Significant decrease of fasting glycemia after the DAA treatment was observed in the whole cohort and in subgroups of patients with T2DM, IFG, cirrhotic, and treatment experienced patients.

CP-153 Effectiveness of new direct acting antivirals for chronic hepatitis C

2016 ◽  
Vol 23 (Suppl 1) ◽  
pp. A67.2-A68
Author(s):  
B Benitez Garcia ◽  
F Moreno Ramos ◽  
Ml Montes Ramirez ◽  
L Martin Carbonero ◽  
L Gonzalez Del Valle ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Direct Acting Antivirals ◽  
Direct Acting
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