Management of chronic hepatitis C in 2017

SummaryHepatitis C virus (HCV) represents one of the most common aetiologies of chronic liver disease and causes a major global health burden. Globally an estimated 80 million people are chronically infected, but the majority of whom is still undiagnosed. Prior to the discovery of the virus in 1989 a significant number of patients were exposed and consecutively infected with HCV via contaminated transfusions, as it is a blood-borne disease. Chronic HCV infection pursues a progressive course that ultimately results in the development of cirrhosis, liver failure and hepatocellular carcinoma (HCC), if left untreated. The efficiency and tolerability of therapeutical approaches improved considerably with the development of direct-acting antivirals (DAA). The majority of patients treated with the recommended DAA combinations can be cured, which is reflected in achievement of sustained virological response (SVR).This review is intended to provide guidance in the management of patients with chronic hepatitis C, including recommendations for adequate screening, diagnostic procedures, clinical care, treatment and follow-up strategies.

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Real-world Effectiveness of Glecaprevir/Pibrentasvir (GLE/PIB) for Chronic Hepatitis C Infection: Evidence From a German Single-center Cohort Study

Hepatitis Monthly ◽

10.5812/hepatmon.110077 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Claudia Beisel ◽

Marissa Herrmann ◽

Felix Piecha ◽

Sibylle Lampalzer ◽

Gustav Buescher ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Real World ◽

Hcv Infection ◽

Single Center ◽

Number Of Patients ◽

Chronic Hcv Infection ◽

Chronic Hcv

Background: Glecaprevir/pibrentasvir (GLE/PIB) is the latest approved pan-genotypic direct-acting antiviral agent (DAA) for the treatment of chronic hepatitis C virus (HCV) infection. However, real-world data of GLE/PIB in European patient cohorts are limited. Methods: A single-center cohort of 100 unselected HCV patients seen at the Outpatient Clinic of the University Medical Center Hamburg-Eppendorf from October 2017 until September 2019 was retrospectively analyzed by chart review with a special focus on demographic clinical and virologic aspects as well as treatment compliance outcome. Results: A total of 99 patients with chronic HCV infection (genotype (GT) 1 - 6), who started antiviral treatment with GLE/PIB, were included. Treatment duration lasted from 4 to 16 weeks. The primary endpoint was a sustained virological response at week 12 (SVR12) after the end of treatment (EoT). Only three patients (3/100; 3%) were diagnosed with liver cirrhosis by non-invasive measures. Ten patients (10/100; 10%) were pre-treated with Interferon (IFN) containing regiments. Most patients received 8 weeks of treatment (96/100; 96%). One patient discontinued treatment after four weeks due to poor compliance (1/100; 1%). A high number of patients were lost to follow-up (22/100; 22%). All patients who were regularly seen to follow-up visits (76/100; 76%) achieved SVR12 (76/76; 100%). Virological relapse occurred in none of the patients. Adverse events (AEs) were rarely reported (4 patients) (4/100; 4%), and none of these patients discontinued treatment. Conclusions: This study demonstrated that initial and re-treatment with GLE/PIB were effective and safe in a German cohort with chronic HCV infection in real-life settings, regardless of GT.

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Evaluation of the Renal Safety of Direct Acting Antivirals in Chronic Hepatitis C Patients

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2021/v23i330226 ◽

2021 ◽

pp. 34-45

Author(s):

Islam Ashram ◽

Mohammad Saleh

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Therapeutic Benefits ◽

Chronic Hcv Infection ◽

One Year ◽

Chronic Hcv ◽

Direct Acting ◽

Chronic Hepatitis C Patients

Objective:Direct acting antivirals (DAA) is a class of antivirals that hasbeen extensively used in chronic hepatitis C virus (HCV) patients over the past 6 years.Despite the excellent therapeutic benefits of DAA, there is a knowledge gap regardingthe safety of this class. Several reports of possible renal toxicity associated with DAAadministration can be found in the literature. The aims of this study are: to assess therenal safety of DAA used for the treatment of chronic HCV infection and to quantify the odds ofdeveloping renaltoxicityin patients withchronicHCV viralinfection. Study Design: Disproportionalityanalysiswasusedtodetectsignalsofpotentialsideeffects. Place andDuration: Amman –Jordan,One year study since September 2017 to march 2018. Methods: The method that was applied in the current study is obtaining the data from United States (US) food and drug administration(FDA)adverseeventreportingsystem(FAERS).DatabetweenJuly,2014andSeptember,2017werecombinedandexplored.Disproportionalityanalysiswasconducted to reports from chronic HCV patients to explore possible association betweenDAA administrationand renalsideeffects. Results: This study showed that a total of 3,837,418 safety reports were available in the period between July,2014 and September, 2017. Patients with chronic HCV infection represent 22,022 cases.When considering all DAA as drug of interest, the use of DAA alone or in combinationwith interferon and/or ribavirin did not increase the risk of having renal side effects.Exploring individual DAA demonstrated a significant association between the incidenceofrenalsideeffectsandtheadministrationoftelapreviranddasabuvir.ConsideringrenalsideeffectsindividuallyshowedasignificantassociationbetweenDAAadministrationand chronickidney disease. Conclusions: In this study, we reported a significant association between DAA administration andchronic kidney disease and between telaprevir or dasabuvir and renal side effect. Thesefindings are used for hypothesis generation rather than testing.

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Newer molecules and new hopes in the management of chronic hepatitis C

JMS SKIMS ◽

10.33883/jms.v13i2.45 ◽

2010 ◽

Vol 13 (2) ◽

pp. 39-40

Author(s):

Showkat Ali Zargar

Keyword(s):

Hepatocellular Carcinoma ◽

Immune Response ◽

Liver Transplantation ◽

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Chronic Infection ◽

Antiviral Therapies ◽

Chronic Hcv Infection ◽

Chronic Hcv

Chronic hepatitis C is highly prevalent with prevalence rate of around 3% involving about 180 million people worldwide, despite major advances in its understanding of viral 1 pathogenesis and significant evolution in antiviral therapies. Most of the patients develop chronic infection because the virus evades the host immune response in majority of patients. Chronic HCV infection can lead to cirrhosis and hepatocellular carcinoma. Complications of HCV-related cirrhosis are the leading indication for liver transplantation in United States and Europe...... J Med Sci 2010;13(2): 39-40.

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Hepatitis C elimination in the Netherlands (CELINE): study protocol for nationwide retrieval of lost to follow-up patients with chronic hepatitis C

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000396 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000396 ◽

Cited By ~ 2

Author(s):

Cas J Isfordink ◽

Sylvia M Brakenhoff ◽

Marleen van Dijk ◽

Marc van der Valk ◽

Rob J de Knegt ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

The Netherlands ◽

Chronic Hepatitis C ◽

Hcv Rna ◽

Ethical Approval ◽

Hcv Transmission ◽

Chronic Hcv ◽

Lost To Follow Up

BackgroundThe Netherlands has a low hepatitis C virus (HCV) prevalence, estimated at 0.16%. Previous studies have shown that up to 30% of the diagnosed HCV population in the Netherlands has been lost to follow-up (LTFU). Retrieval of these patients could halt progression of liver disease in infected patients, reduce the number of infected individuals and limit HCV transmission. Several regional Dutch retrieval projects have already been executed, which demonstrated that retrieval is feasible. Therefore, we initiated a nationwide retrieval project, aiming to achieve microelimination in previously diagnosed but LTFU patients with chronic HCV through retrieval.MethodsLaboratory records will be used to identify possible patients with chronic hepatitis C, defined as either a positive most recent HCV RNA or positive HCV antibodies without known RNA result. Reviewing patient records and obtaining current contact information from municipality databases will identify LTFU patients who are eligible for retrieval. These patients will be invited for outpatient clinic care. The primary outcome of the study is the total number of LTFU patients who have been successfully linked to care.DiscussionHepatitis C ELimination In the NEtherlands (CELINE) is within the remit of WHO elimination targets and the Dutch National Hepatitis Plan. The methodology of CELINE is based on previously conducted regional retrieval projects and is designed to overcome some of their limitations. After ethical approval was obtained in 2018, the first centre initiated retrieval in 2018 and the project is expected to finish in 2021.Trial registration numberNCT04208035.

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Real-world single-center experience with direct-acting antivirals for improvement of the liver fibrosis after chronic hepatitis C treatment

Antiviral Chemistry and Chemotherapy ◽

10.1177/2040206620974835 ◽

2020 ◽

Vol 28 ◽

pp. 204020662097483

Author(s):

Sun Hee Lee ◽

Hyun Phil Shin ◽

Joung Il Lee

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Fibrosis ◽

Chronic Hepatitis C ◽

Liver Stiffness ◽

Serum Biomarkers ◽

Post Treatment ◽

Direct Acting Antivirals ◽

Number Of Patients ◽

Direct Acting

Background Recently, new direct-acting antivirals (DAAs) are known to eradicate chronic hepatitis C (CHC) virus infection and prevent the progression of liver fibrosis. Liver fibrosis may predispose to liver cirrhosis or hepatocellular carcinoma. We investigated the effect of DAAs on liver fibrosis using non-invasive methods, and evaluated the correlations of these methods. Methods We retrospectively analyzed 68 patients with CHC who were treated with DAAs and reached sustained virologic response at 12 weeks post-treatment from January 2016 to October 2018. The degree of liver fibrosis was assessed using serum biomarkers, such as AST-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) index. Liver stiffness was assessed using two-dimensional shear-wave elastography (2 D-SWE). The pre- and post-treatment serum biomarker levels and SWE findings were evaluated and compared. Results A total of 68 patients with CHC were enrolled. The median age was 58 years (52.3–73 years) and 37 patients (54.4%) were female. After treatment, the median APRI was decreased from 0.701 to 0.328 (P < 0.0001), and the median FIB-4 was decreased from 2.355 to 1.860 (P < 0.0001). The median kPa in 2 D-SWE significantly reduced from 6.85 to 5.66 (P = 0.013). APRI and FIB-4 were significantly correlated pre- and post-treatment; however, the correlation between the serum biomarkers and 2 D-SWE was partially significant. Conclusion The serum fibrosis biomarkers and liver stiffness on 2 D-SWE were shown to be improved after the treatment with DAAs. Further research including larger number of patients is needed to compare the efficacy of each evaluating method.

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Duration of Chronic HCV Infection and Efficacy of Interferon in Chronic Hepatitis C Patients with a History of Blood Transfusion

Kansenshogaku zasshi ◽

10.11150/kansenshogakuzasshi1970.71.405 ◽

1997 ◽

Vol 71 (5) ◽

pp. 405-411

Author(s):

Michio SATA ◽

Masayoshi KAGE ◽

Osami INOUE ◽

Seigo SAKAGUCHI ◽

Michitami YANO ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Blood Transfusion ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

History Of ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

Chronic Hepatitis C Patients

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Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

Canadian Journal of Gastroenterology ◽

10.1155/2009/370651 ◽

2009 ◽

Vol 23 (6) ◽

pp. 425-430 ◽

Cited By ~ 9

Author(s):

Jennifer A Flemming ◽

David J Hurlbut ◽

Ben Mussari ◽

Lawrence C Hookey

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Biopsy ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Significant Difference ◽

The Us ◽

Chronic Hcv Infection ◽

Liver Biopsies ◽

Chronic Hcv

BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV)-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US)-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.METHODS: Liver biopsies from 100 patients with chronic HCV infection (50 consecutive US-guided and 50 consecutive non-US-guided), were retrospectively identified using a hospital histopathology database. All original biopsy slides were coded and prospectively reanalyzed by a single hepatopathologist who was blinded to the technique used in obtaining the biopsy. Additionally, all liver biopsies for chronic HCV infection completed at the centre from 1998 to 2007 were identified and the technique used was recorded. Biopsy quality was determined primarily by the number of complete portal tracts (CPTs) identifiable in the slides. The total length of specimen and the degree of fragmentation were secondary outcome measures.RESULTS: There was a slight difference observed between the US-guided and non-US-guided groups in mean age (46.3 years versus 42.5 years, repectively; P=0.018) but no differences in sex, presence of cirrhosis, bilirubin, creatinine, international normalized ratio, and grade or stage of disease. Biopsies obtained using the US-guided technique produced higher quality specimens than the non-US-guided technique based on our primary outcome of number of CPTs in the biopsy (11.8 versus 7.4; P<0.001). US-guided specimens also were longer (24.4 mm versus 19.7 mm; P=0.001), had less fragmentation (P=0.016), and a higher overall histopathological quality assessment (P=0.026) than the non-US-guided biopsies. However, there was no significant difference between the two groups in the ability to grade and stage the disease (96% US-guided versus 90% in non-US-guided (P=0.20). Over a 10-year period, 763 biopsies for chronic HCV infection were identified with an obvious trend toward the increased use of US-guided technique observed at 2% in 1998 to 85% in 2007.CONCLUSIONS: US-guided liver biopsies for chronic HCV are the most common method of obtaining specimens at the Kingston General Hospital, Kingston, Ontario, and are of higher quality than non-US-guided specimens. However, there is no significant difference in the two techniques in the ability to grade and stage chronic HCV.

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The Correlation between miR-122 and Lipoprotein Lipase Expression in Chronic Hepatitis C Patients

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/6348948 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Malgorzata Sidorkiewicz ◽

Martyna Grek-Kowalinska ◽

Anna Piekarska

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Chronic Hepatitis C ◽

Lipoprotein Metabolism ◽

Hcv Rna ◽

Chronic Hcv Infection ◽

Liver Biopsies ◽

Chronic Hcv ◽

First Time ◽

Chronic Hepatitis C Patients

Chronic HCV infection is strictly associated with host lipid/lipoprotein metabolism disorders. The study aimed to analyze the relationship between viral load, lipid profile, IFNγ, and the expression of miR-122 and LPL in the liver and PBMCs. Sera, PBMCs, and matching liver biopsies from 17 chronic hepatitis C patients were enrolled in this study. Collected data shows that liver (not PBMCs) miR-122 expression is positively correlated with HCV RNA load and IFNγ and reversely with LPL expression in CHC patients. Presented, for the first time, in this study, the reverse correlation of miR-122 and LPL expression in liver; miR-122 and LPL seem to be important factors of CHC infection.

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Chronic HCV - infection in the Kirov region: Dynamics of indices of disease in adults in 1995-2010

Epidemiology and Infectious Diseases (Russian Journal) ◽

10.17816/eid40712 ◽

2013 ◽

Vol 18 (2) ◽

pp. 33-36

Author(s):

S. V Baramzina

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Acute Hepatitis ◽

Chronic Hepatitis C ◽

Hcv Infection ◽

Acute Hepatitis C ◽

Chronic Hcv Infection ◽

Chronic Hcv ◽

The Given ◽

Epidemiological Situation

In the given article the analysis of an epidemiological situation concerning chronic forms of HCV infections in adults in the Kirov region in 1995-2010 is presented. In the region during analyzed period stable trend to the elevation of incidence of chronic hepatitis C and a slight decrease in the number of "carriers" of HCV on the background of steadily low indices of the occurrence of acute hepatitis C have been fixed. There are also presented the results of genotyping of HCV-virus in 730 patients with chronic hepatitis C treated at the Kirov Region infectious hospital and polyclinics in Kirov with the dominance of HCV subtypes 1b and 3a .

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