scholarly journals Efficacy of Glecaprevir/Pibrentasvir for Real-World HCV Infected Patients in the Northern Part of Tokyo, Japan

2021 ◽  
Vol 10 (23) ◽  
pp. 5529
Author(s):  
Yoichiro Yamana ◽  
Tatsuo Kanda ◽  
Naoki Matsumoto ◽  
Masayuki Honda ◽  
Mariko Kumagawa ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Combination Treatment ◽  
Real World ◽  
Nonstructural Protein ◽  
Virologic Response ◽  
Direct Acting Antiviral ◽  
Compensated Cirrhosis ◽  
Ns5a Region ◽  
Virus C ◽  
Direct Acting

Hepatis virus C (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. The objective of our study was to examine the effects of the HCV nonstructural protein (NS) 3/4A inhibitor glecaprevir/NS5A inhibitor pibrentasvir on real-world HCV patients in the northern part of Tokyo, Japan. Although 106 patients were consecutively included, a total of 102 HCV-infected patients with chronic hepatitis or compensated cirrhosis, who received 8- or 12-week combination treatment with glecaprevir/pibrentasvir and were followed up to week 12 after the end of treatment were analyzed retrospectively. Only three patients discontinued treatment due to adverse events; however, they achieved a sustained virologic response at 12 weeks (SVR12). Finally, SVR rates were 99.0% (101/102). Only one patient without liver cirrhosis was a treatment relapser who received hepatic resection for HCC approximately two years after commencement of the 8-week combination treatment with glecaprevir/pibrentasvir. After the exclusion of patients with HCV genotype 1b and P32 deletion in the HCV NS5A region, a 12-week combination of glecaprevir/pibrentasvir led to SVR12 in all nine direct-acting antiviral-experienced patients. Glecaprevir/pibrentasvir had a high efficacy and an acceptable safety profile for real-world HCV patients in a single hospital in Japan.

scholarly journals Incidence and Impact of Persistent Viremia on SVR Rates in Patients Receiving Direct-Acting Antiviral Therapy

2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Alicia B Carver ◽  
Autumn D Zuckerman ◽  
Joshua DeClercq ◽  
Leena Choi ◽  
Cody A Chastain
Keyword(s):  
Antiviral Therapy ◽  
Real World ◽  
Sustained Virologic Response ◽  
Response Rates ◽  
Virologic Response ◽  
Direct Acting Antiviral ◽  
Rapid Virologic Response ◽  
Persistent Viremia ◽  
Direct Acting ◽  
High Sustained Virologic Response

Abstract Rates of persistent viremia (PV) while on direct-acting antiviral therapy were low (5.7%) in a real-world cohort of 983 patients. High sustained virologic response rates were achieved both in patients with PV (92.9%) and those with rapid virologic response (96.5%), without significant differences.

scholarly journals Factors associated with hepatocellular carcinoma occurrence after HCV eradication in patients without cirrhosis or with compensated cirrhosis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243473
Author(s):  
Kazumichi Abe ◽  
Hiroto Wakabayashi ◽  
Haruo Nakayama ◽  
Tomohiro Suzuki ◽  
Masahito Kuroda ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multivariate Analysis ◽  
Survival Rates ◽  
Virologic Response ◽  
Female Ratio ◽  
Factors Affecting ◽  
Direct Acting Antiviral ◽  
Compensated Cirrhosis ◽  
Male Female Ratio ◽  
Direct Acting

The present study aimed to investigate the incidence of hepatocellular carcinoma (HCC) and factors related to HCC occurrence after direct-acting antiviral (DAA) treatment in the Fukushima Liver Academic Group (FLAG). We conducted a multicenter retrospective cohort study of 1068 patients without cirrhosis (NC) or with compensated liver cirrhosis (LC) who achieved a sustained virologic response (SVR). First, we compared the cumulative HCC incidence and survival rates in NC (n = 880) and LC (n = 188) patients without a history of HCC treatment. Second, we performed multivariate analysis of factors related to HCC occurrence after DAA treatment. Overall, the average age was 65 years, and the male/female ratio was 511/557. Thirty-nine (4%) patients developed HCC. The cumulative 4-year HCC incidence and survival rates were 3.0% and 99.8% in NC patients and 11.5% and 98.5% in LC patients, respectively. The independent factors affecting HCC occurrence identified by multivariate analysis were the serum albumin (ALB) level before SVR for NC patients and the ALBI score, platelet count, and diabetes before SVR for LC patients. The factors related to HCC occurrence differed between NC and LC patients. Careful surveillance of post-SVR patients with these risk factors is needed.

HCV GT1b-patient with alanine aminotransferase elevation and sustained virologic response achieved by grazoprevir/elbasvir discontinuation

2021 ◽  
Author(s):  
Hiroshi Takahashi ◽  
Tatsuo Kanda ◽  
Naoki Matsumoto ◽  
Taku Mizutani ◽  
Tomohiro Kaneko ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Alanine Aminotransferase ◽  
Sustained Virologic Response ◽  
Nonstructural Protein ◽  
Present Report ◽  
Virologic Response ◽  
Hcv Infection ◽  
Short Treatment ◽  
Direct Acting Antiviral ◽  
Direct Acting

In the present Japanese female patient with alanine aminotransferase (ALT) elevation greater than 500 IU/l during combination therapy with grazoprevir/elbasvir against HCV infection, this therapy was stopped at week 8. However, sustained virologic response was achieved. In the present report, we also focused on ALT elevation and sustained virologic response during and after antiviral therapies. The current case report demonstrates that careful monitoring of liver function tests may be required during direct-acting antiviral therapy against HCV infection because it is now possible to treat patients with polypharmacy, patients with chronic kidney disease, patients with cirrhosis or aged patients. Careful attention should be paid to liver damage as one of the adverse events in the use of HCV nonstructural protein 3/4A protease inhibitors. Of interest, many publications have addressed both ALT elevations during direct-acting antiviral therapy and viral clearance in relatively short treatment durations.

scholarly journals Severe hyponatremia after direct-acting antiviral treatment in a patient with virus C compensated liver cirrhosis and kidney transplant

2018 ◽  
Vol 27 (2) ◽  
pp. 203-204
Author(s):  
Cătălina Mihai ◽  
Bogdan Mircea Mihai ◽  
Mihaela Dranga ◽  
Vasile Liviu Drug ◽  
Adrian Covic ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Kidney Transplant ◽  
Antiviral Treatment ◽  
Severe Hyponatremia ◽  
Direct Acting Antiviral ◽  
Virus C ◽  
Direct Acting

.

Sofosbuvir, velpatasvir, and voxilaprevir for patients with failure of previous direct-acting antiviral therapy for chronic hepatitis C: Results from the German Hepatitis C-Registry (DHC-R)

2020 ◽  
Vol 58 (09) ◽  
pp. 841-846
Author(s):  
Heiner Wedemeyer ◽  
Johannes Vermehren ◽  
Yvonne Serfert ◽  
Markus Cornberg ◽  
Albrecht Stoehr ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Adverse Events ◽  
Real World ◽  
Virologic Response ◽  
Combination Regimen ◽  
Direct Acting Antivirals ◽  
High Effectiveness ◽  
Direct Acting Antiviral ◽  
Direct Acting

AbstractDespite the high effectiveness of direct-acting antivirals for the treatment of hepatitis C, a small proportion of patients do not respond to approved regimens. The combination regimen of SOF/VEL/VOX was recently approved for patients with failure to prior NS5A-based treatment. In this German real-world cohort including patients with cirrhosis (27.3 %) and previous decompensation events, 12 weeks of SOF/VEL/VOX resulted in high virologic response rates irrespective of disease severity and prior DAA regimen. Adverse events were mostly mild or moderate and comparable to those seen in the approval studies.

scholarly journals Effect on Hepatitis C Virus Replication of Combinations of Direct-Acting Antivirals, Including NS5A Inhibitor Daclatasvir

2012 ◽  
Vol 56 (10) ◽  
pp. 5230-5239 ◽  
Author(s):  
Lenore A. Pelosi ◽  
Stacey Voss ◽  
Mengping Liu ◽  
Min Gao ◽  
Julie A. Lemm
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Combination Treatment ◽  
Target Gene ◽  
Nonstructural Protein ◽  
Synergistic Effects ◽  
Antiviral Agents ◽  
Strong Support ◽  
Direct Acting Antiviral ◽  
Direct Acting

ABSTRACTThree hepatitis C virus (HCV) inhibitors, asunaprevir (ASV; BMS-650032), daclatasvir (DCV; BMS-790052), and BMS-791325, each targeting a different nonstructural protein of the virus (NS3, NS5A, and NS5B, respectively), have independently demonstrated encouraging preclinical profiles and are currently undergoing clinical evaluation. Since drug-resistant variants have rapidly developed in response to monotherapy with almost all direct-acting antiviral agents (DAAs) for HCV, the need for combination therapies to effectively eradicate the virus from infected patients is clear. These studies demonstrated the additive-synergistic effects on replicon inhibition and clearance of combining NS3 protease or NS5B RNA polymerase inhibitors with the first-in-class, NS5A replication complex inhibitor daclatasvir (DCV) and reveal new resistance pathways for combinations of two small-molecule inhibitors that differ from those that develop during monotherapy. The results suggest that under a specific selective pressure, a balance must be reached in the fitness costs of substitutions in one target gene when substitutions are also present in another target gene. Further synergies and additional novel resistance substitutions were observed during triple-combination treatment relative to dual-drug therapy, indicating that, in combination, HCV inhibitors can exert cross-target influences on resistance development. Enhanced synergies in replicon inhibition and a reduced frequency of resistance together lend strong support to the utility of combinations of DAAs for the treatment of HCV, and the identification of altered resistance profiles during combination treatment provides useful information for monitoring resistance in the clinic.

New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania

2017 ◽  
Vol 26 (4) ◽  
pp. 381-386
Author(s):  
Mircea Manuc ◽  
Carmen M. Preda ◽  
Corneliu P. Popescu ◽  
Cristian Baicuș ◽  
Theodor Voiosu ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Users ◽  
Antiviral Agent ◽  
Virologic Response ◽  
Advanced Fibrosis ◽  
Direct Acting Antiviral ◽  
Genotype 1B ◽  
Direct Acting ◽  
End Stage

Background & Aims: Literature data suggest that HCV genotype-1b is present in 93-99% of the Romanian patients infected with hepatitis C virus (HCV). We present the genotyping tests recently performed on patients with HCV and advanced fibrosis eligible for the Direct-Acting Antiviral (DAA) therapy, as well as the prevalence of these cases across Romania.Methods: The genotyping method was performed on 7,421 HCV patients with advanced fibrosis. The detection method was automatic real time PCR platform M2000 (Abbott). Every subject was introduced into a database including age, sex, county and address.Results: Genotype 1b was almost exclusively present: 7,392/7,421 (99.6%). Genotype 1b patients were 19.6% from Bucharest, 49% were males, with a median age of 60 years. Genotype non-1b was encountered in 29/7,421 subjects (0.4%), 62% were males, 69% from Bucharest and the median age was 52 years. Most of the subjects (75%) were in the 6th and 7th age decade. The prevalence of these cases varied significantly across Romanian counties: the highest was in Bucharest (61.3/105), Bihor (47/105), Iasi (46/105) and Constanța (43/105), and the lowest in Ilfov (2.8/105), Harghita (3.7/105), Covasna (5.4/105) and Maramureș (8.8/105) (p<0.001).Conclusions: Genotype 1b is encountered in 99.6% of patients with chronic hepatitis C and advanced fibrosis from Romania. The presence of genotypes non-1b is more common in Bucharest, in males and at a younger age. There are significant differences regarding the distribution of these cases across Romania: the highest rates are in Bucharest, Bihor, Iasi and Constanta.Abbreviations: BMI: body mass index; DAA: direct-acting antiviral agent; GT: genotype; HBV: hepatitis B virus; HCC: hepatocellular carcinoma; HCV: hepatitis C virus; IDU: intravenous drug users; MELD: model for end stage liver disease; NASH: non-alcoholic steatohepatitis; SVR; sustained virologic response.

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