scholarly journals The impact of Sofosbuvir/Velpatasvir/Voxilaprevir treatment on serum hyperglycemia in HCV infections: A Systematic Review

2021 ◽  
Author(s):  
Hsuan-Yu Hung ◽  
◽  
Chung-Yu Chen
Keyword(s):  
Information Sources ◽  
Rescue Therapy ◽  
Therapy Regimen ◽  
Direct Acting Antiviral ◽  
Improve Insulin Resistance ◽  
Review Question ◽  
Grade 3 ◽  
Direct Acting ◽  
The Impact ◽  
Possible Cause

Review question / Objective: To assess the possible cause of events, the incidence of grade 3 hyperglycemia after treating Sofosbuvir/Velpatasvir/Voxilaprevir in HCV infections. Condition being studied: Sofosbuvir, velpatasvir, and voxilaprevir (SOF/VEL/VOX) is an effective, safe rescue therapy regimen for patients have previously been treated failure. Initiating Direct-Acting Antiviral (DAA) treatment for HCV infection with diabetes have experienced hypoglycemia, it could improve insulin resistance due to clean HCV. However, some studies shown that SOF/VEL/VOX has Grade 3 hyperglycemia adverse events. This finding contradicts that other DAAs studies. Information sources: Conducting a comprehensive literature search on the pubmed, Cochrane, clinicalkey, Embase, and MEDLINE electronic databases.

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.

Exploring the emotions of patients undergoing therapy for hepatitis C

2019 ◽  
Vol 17 (Sup6) ◽  
pp. S18-S21
Author(s):  
Sarah Montague ◽  
Kosh Agarwal ◽  
Mary Cannon
Keyword(s):  
Hepatitis C ◽  
Physical Health ◽  
Viral Hepatitis ◽  
Patient Engagement ◽  
Health Benefits ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Positive Outlook ◽  
The Impact ◽  
Single Question

Background: direct-acting antiviral (DAA) therapy is highly efficacious in the treatment of hepatitis C (HCV). The literature to date has focused primarily on the physical health benefits of viral eradication. Aims: this study explored patient emotions during and after DAA therapy for HCV. Methods: over a 6-month period, 178 patients attending a viral hepatitis clinic for treatment of HCV were posed a single question: ‘How do you feel about your diagnosis of hepatitis C today?’ Responses were transcribed verbatim, thematically coded and visualised using WordArt software. Findings: the images depict the evolution of patients' perceptions of HCV before, during and after DAA therapy. Responses before treatment were predominantly negative, often describing the fear of contagion and feelings of isolation, secrecy and loneliness. After treatment, patients often described feeling positive and more motivated. Conclusions: the results demonstrate that treatment of HCV has a transformative effect on patients' perception of the impact of HCV on their wellbeing. This may promote a more positive outlook and, in turn, facilitate patient engagement with healthcare.

scholarly journals Population impact of direct-acting antiviral treatment on new presentations of hepatitis C-related decompensated cirrhosis: a national record-linkage study

Gut ◽  
2020 ◽  
Vol 69 (12) ◽  
pp. 2223-2231 ◽  
Author(s):  
Sharon J Hutchinson ◽  
Heather Valerio ◽  
Scott A McDonald ◽  
Alan Yeung ◽  
Kevin Pollock ◽  
...  
Keyword(s):  
Antiviral Treatment ◽  
Scale Up ◽  
Sustained Viral Response ◽  
Population Based ◽  
Decompensated Cirrhosis ◽  
Direct Acting Antiviral ◽  
Clinical Databases ◽  
Number Of Patients ◽  
Direct Acting ◽  
The Impact

ObjectivePopulation-based studies demonstrating the clinical impact of interferon-free direct-acting antiviral (DAA) therapies are lacking. We examined the impact of the introduction of DAAs on HCV-related decompensated cirrhosis (DC) through analysis of population-based data from Scotland.DesignThrough analysis of national surveillance data (involving linkage of HCV diagnosis and clinical databases to hospital and deaths registers), we determined i) the scale-up in the number of patients treated and achieving a sustained viral response (SVR), and ii) the change in the trend of new presentations with HCV-related DC, with the introduction of DAAs.ResultsApproximately 11 000 patients had been treated in Scotland over the 8-year period 2010/11 to 2017/18. The scale-up in the number of patients achieving SVR between the pre-DAA and DAA eras was 2.3-fold overall and 5.9-fold among those with compensated cirrhosis (the group at immediate risk of developing DC). In the pre-DAA era, the annual number of HCV-related DC presentations increased 4.6-fold between 2000 (30) and 2014 (142). In the DAA era, presentations decreased by 51% to 69 in 2018 (and by 67% among those with chronic infection at presentation), representing a significant change in trend (rate ratio 0.88, 95% CI 0.85 to 0.90). With the introduction of DAAs, an estimated 330 DC cases had been averted during 2015–18.ConclusionsNational scale-up in interferon-free DAA treatment is associated with the rapid downturn in presentations of HCV-related DC at the population-level. Major progress in averting HCV-related DC in the short-term is feasible, and thus other countries should strive to achieve the same.

scholarly journals Lymphocyte Landscape after Chronic Hepatitis C Virus (HCV) Cure: The New Normal

2020 ◽  
Vol 21 (20) ◽  
pp. 7473
Author(s):  
Alip Ghosh ◽  
Sara Romani ◽  
Shyam Kottilil ◽  
Bhawna Poonia
Keyword(s):  
Hepatocellular Carcinoma ◽  
Immune System ◽  
Virologic Response ◽  
Viral Clearance ◽  
Liver Pathology ◽  
Direct Acting Antiviral ◽  
Chronic Hcv ◽  
Direct Acting ◽  
Immune Defects ◽  
The Impact

Chronic HCV (CHC) infection is the only chronic viral infection for which curative treatments have been discovered. These direct acting antiviral (DAA) agents target specific steps in the viral replication cycle with remarkable efficacy and result in sustained virologic response (SVR) or cure in high (>95%) proportions of patients. These treatments became available 6–7 years ago and it is estimated that their real impact on HCV related morbidity, including outcomes such as cirrhosis and hepatocellular carcinoma (HCC), will not be known for the next decade or so. The immune system of a chronically infected patient is severely dysregulated and questions remain regarding the immune system’s capacity in limiting liver pathology in a cured individual. Another important consequence of impaired immunity in patients cleared of HCV with DAA will be the inability to generate protective immunity against possible re-infection, necessitating retreatments or developing a prophylactic vaccine. Thus, the impact of viral clearance on restoring immune homeostasis is being investigated by many groups. Among the important questions that need to be answered are how much the immune system normalizes with cure, how long after viral clearance this recalibration occurs, what are the consequences of persisting immune defects for protection from re-infection in vulnerable populations, and does viral clearance reduce liver pathology and the risk of developing hepatocellular carcinoma in individuals cured with these agents. Here, we review the recent literature that describes the defects present in various lymphocyte populations in a CHC patient and their status after viral clearance using DAA treatments.

Exploring the emotions of patients undergoing therapy for hepatitis C

2019 ◽  
Vol 28 (13) ◽  
pp. 824-828 ◽  
Author(s):  
Sarah Montague ◽  
Kosh Agarwal ◽  
Mary Cannon
Keyword(s):  
Hepatitis C ◽  
Physical Health ◽  
Viral Hepatitis ◽  
Patient Engagement ◽  
Health Benefits ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Positive Outlook ◽  
The Impact ◽  
Single Question

Background: direct-acting antiviral (DAA) therapy is highly efficacious in the treatment of hepatitis C (HCV). The literature to date has focused primarily on the physical health benefits of viral eradication. Aims: this study explored patient emotions during and after DAA therapy for HCV. Methods: over a 6-month period, 178 patients attending a viral hepatitis clinic for treatment of HCV were posed a single question: ‘How do you feel about your diagnosis of hepatitis C today?’ Responses were transcribed verbatim, thematically coded and visualised using WordArt software. Findings: the images depict the evolution of patients' perceptions of HCV before, during and after DAA therapy. Responses before treatment were predominantly negative, often describing the fear of contagion and feelings of isolation, secrecy and loneliness. After treatment, patients often described feeling positive and more motivated. Conclusions: the results demonstrate that treatment of HCV has a transformative effect on patients' perception of the impact of HCV on their wellbeing. This may promote a more positive outlook and, in turn, facilitate patient engagement with healthcare.

Safety & Efficacy of Directly Acting Antivirals (Sofosbuvir & Daclatasvir) in Treatment of Chronic HCV in HIV-HCV Co-Infected Egyptian Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Kadry Mohamed EL-Saeed ◽  
Inas EL-Khedr ◽  
Christina Alphonse Anwar ◽  
Mahmoud Hassan Al-Sadik Hassan
Keyword(s):  
Antiviral Agents ◽  
Fever Hospital ◽  
Duration Of Treatment ◽  
Direct Acting Antiviral ◽  
Immune Correlates ◽  
Safety Parameters ◽  
Chronic Hcv ◽  
Direct Acting ◽  
The Impact ◽  
Direct Acting Antiviral Agents

Abstract Background The introduction of direct-acting antiviral agents, has revolutionized the treatment for chronic HCV with higher cure rates, shorter duration of treatment and more tolerability have been achieved. Objectives The aim of our study is to estimate the efficacy and safety of DAAs in treatment of chronic HCV in patients co-infected with HIV. Patients and Methods This study of previously untreated patients with HCV and HIV co- infection conducted at Abbasia Fever Hospital, from July 2019 to February 2020. Patients included those who are chronic HCV infection and receiving antiretroviral therapy with a CD4 T-lymphocyte count of 200 cells/mL or greater. Serial measurements of safety parameters, virologic and host immune correlates, and adherence were performed during treatment by combination of daclatasvir 90mg and sofosbuvir 400mg+/- ribavirin 800mg daily for 12 weeks. Results In this study, AST & ALT were significantly decreased at end of treatment and 12 weeks after treatment, CD4 count was significantly increased. Otherwise there are no significant changes in both hematological and biochemical laboratory results. The demographic features of the patients and HIV disease characteristics were not predictors of HCV treatment failure. Conclusion More studies on larger numbers of patients are required for proper evaluation of the safety and efficacy of direct acting antiviral agents generally and sofosbuvir plus daclatasvir combination particularly in HIV/HCV coinfected patients. Longer follow-up studies are still recommended to fully understand the impact of sustained virological response on dynamics of liver fibrosis, biochemical profile and rate of relapse.

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