Baseline Characteristics and Treatment Cost of Hepatitis C at
Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam in
Direct-Acting Antiviral Treatment Era

Nguyen, Dung; Tran, Tuan; Nghiem, Ngoc My; Nguyen, Harrison P.; Le, Phuong; Vo, Quang Minh; Le, Hung; Rahman, Motiur

doi:10.17554/j.issn.2224-3992.2019.08.857

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…Our data add to the limited number of reports on treatment response that have emerged from Asian countries, including Vietnam [17,23]. Similar to earlier studies, we documented a high prevalence (54.7% of cases) of HCV genotype 6 among patients attending our hospital [24]. This might be due to lower rate of spontaneous clearance of HCV genotype 6 than other genotypes or genotype 6 infections respond poorly to historical (non-DAA) anti-HCV therapy (e.g.…”

Section: Discussionsupporting

confidence: 90%

“…We found that patients with genotype 6 infections tended to have higher baseline viral loads than patients with genotype 1 infections. The consistency of this finding with previous studies suggests that genotype 6 virus may have a higher replication rate than genotype 1 virus [24].…”

Section: Discussionsupporting

confidence: 89%

“…The majority of patients in our study received a 12 week treatment course. This is probably because the 12 week treatment course is PLOS ONE significantly cheaper than 24 weeks, although patient convenience and adherence may also have been part of clinical decision making [24]. The American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), and the Asian-Pacific Association for the Study of the Liver (APASL) recommend daily fixed-dose combination of i) glecaprevir/pibrentasvir for 8 weeks, ii) sofosbuvir/velpatasvir for 12 weeks, iii) SOF/LDV for 12 weeks, or iv) SOF/DAC for 12 weeks for treatment naïve HCV genotype 6 patients [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of sofosbuvir based direct-acting antiviral regimens for chronic hepatitis C virus genotype 6 patients: Real-world experience in Vietnam

et al. 2020

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Background Hepatitis C virus (HCV) genotype 6 is the commonest cause of chronic hepatitis C infection in much of southeast Asia, but data on the effectiveness of direct-acting antiviral agents (DAAs) against this genotype are limited. We conducted a retrospective cohort study of patients attending the Hospital for Tropical Diseases (HTD), Ho Chi Minh City, Vietnam, to define the effectiveness of DAAs in the treatment of chronic HCV genotype 6 in actual practice. Methods We included all patients with genotype 6 infections attending our hospital between March 2016 and October 2017 who received treatment with sofosbuvir-based DAA treatment regimens, and compared their responses with those with genotype 1 infections. Results 1758 patients (1148 genotype 6, 65.4%; 610 genotype 1, 34.6%) were analyzed. The majority of patients (1480, 84.2%) received sofosbuvir/ledipasvir (SOF/LDV) ± ribavirin (RBV); 278 (15.8%) received sofosbuvir/Daclatasvir (SOF/DCV) ± RBV. The median age of the patients was 57 years, (interquartile range (IQR) 46-64 years) The baseline HCV viral load (log IU/ml) was significantly higher in patients infected with genotype 6 compared with those infected with genotype 1 (6.8, 5.3-6.6 versus 6.3, 5.3-6.5 log10 IU/ml, p = <0.001, Mann Whitney U test). A sustained virological response (SVR), defined as an undetectable viral load measured between 12 and 24 weeks after completing treatment, and indicating cure, was seen in 97.3% (1711/1758) of patients. Treatment failure, defined as HCV viral load �15 IU/ml �12 weeks after completing treatment appeared to be more frequent in patients

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Effectiveness of sofosbuvir based direct-acting antiviral regimens for chronic hepatitis C virus genotype 6 patients: Real-world experience in Vietnam

et al. 2020

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“…In Vietnam, DAA therapy remains prohibitively expensive for many of those infected. A standard 12-week course of sofosbuvir and daclatasvir (SOF/DCV) was priced at US$2417–2472 in Ho Chi Minh City (HCMC) in 2019 ( Nguyen Thanh et al, 2019 ). Despite the government subsidising 50% of drug costs since, the Ministry of Health estimates only 1000 individuals accessed DAA treatment through health insurance in 2019, and 2700 in 2020 ( Ministry of Health V, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for hepatitis C in a single-arm mechanistic pilot study

Flower

Hung²,

McCabe

et al. 2023

eLife

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Background: WHO has called for research into predictive factors for selecting persons who could be successfully treated with shorter durations of direct acting antiviral (DAA) therapy for Hepatitis C. We evaluated early virological response as a means of shortening treatment and explored host, viral and pharmacokinetic contributors to treatment outcome. Methods: Duration of sofosbuvir and daclatasvir (SOF/DCV) was determined according to day 2 (D2) virologic response for HCV genotype (gt) 1- or 6-infected adults in Vietnam with mild liver disease. Participants received 4- or 8-weeks treatment according to whether D2 HCV RNA was above or below 500 IU/ml (standard duration is 12 weeks). Primary endpoint was sustained virological response (SVR12). Those failing therapy were retreated with 12 weeks SOF/DCV. Host IFNL4 genotype and viral sequencing was performed at baseline, with repeat viral sequencing if virological rebound was observed. Levels of SOF, its inactive metabolite GS-331007 and DCV were measured on day 0 and 28. Results: Of 52 adults enrolled, 34 received 4 weeks SOF/DCV, 17 got 8 weeks and one withdrew. SVR12 was achieved in 21/34 (62%) treated for 4 weeks, and 17/17 (100%) treated for 8 weeks. Overall, 38/51 (75%) were cured with first-line treatment (mean duration 37 days). Despite a high prevalence of putative NS5A-inhibitor resistance associated substitutions (RAS), all first-line treatment failures cured after retreatment (13/13). We found no evidence treatment failure was associated with host IFNL4 genotype, viral subtype, baseline RAS, SOF or DCV levels. Conclusions: Shortened SOF/DCV therapy, with retreatment if needed, reduces DAA use in patients with mild liver disease, while maintaining high cure rates. D2 virologic response alone does not adequately predict SVR12 with 4 weeks treatment. Funding: Funded by the Medical Research Council (grant MR/P025064/1) and The Global Challenges Research Fund (Wellcome Trust Grant 206/296/Z/17/Z).) Clinical trial number: ISRCTN17100273

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“…In Vietnam DAA therapy remains prohibitively expensive for many of those infected. A standard twelve-week course of sofosbuvir and daclatasvir (SOF/DCV) was priced at US$2417 - 2472 in Ho Chi Minh City in 2019 3 . Despite the government subsidising 50% of drug costs since, the Ministry of Health estimate only 1000 individuals accessed DAA treatment through health insurance in 2019, and 2700 in 2020 4 .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for Hepatitis C: a single arm mechanistic pilot study

Flower

Hung

McCabe

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Background: WHO has called for research into predictive factors for selecting persons who could be successfully treated with shorter durations of direct acting antiviral (DAA) therapy for Hepatitis C. We evaluated early virological response as a means of shortening treatment and explored host, viral and pharmacokinetic contributors to treatment outcome. Methods: Duration of sofosbuvir and daclatasvir (SOF/DCV) was determined according to day 2 (D2) virologic response for HCV genotype (gt) 1- or 6-infected adults in Vietnam with mild liver disease. Participants received 4 or 8 weeks treatment according to whether D2 HCV RNA was above or below 500 IU/ml (standard duration is 12 weeks). Primary endpoint was sustained virological response (SVR12). Those failing therapy were retreated with 12 weeks SOF/DCV. Host IFNL4 genotype and viral sequencing was performed at baseline, with repeat viral sequencing if virological rebound was observed. Levels of SOF, its inactive metabolite GS-331007 and DCV were measured on day 0 and 28. Results: Of 52 adults enrolled, 34 received 4 weeks SOF/DCV, 17 got 8 weeks and one withdrew. SVR12 was achieved in 21/34 (62%) treated for 4 weeks, and 17/17 (100%) treated for 8 weeks. Overall 38/51 (75%) were cured with first-line treatment (mean duration 37 days). Despite a high prevalence of putative NS5A-inhibitor resistance associated substitutions (RAS), all first-line treatment failures cured after retreatment (13/13). We found no evidence treatment failure was associated with host IFNL4 genotype, viral subtype, baseline RAS or DCV levels. SOF metabolite levels were higher in those failing 4-week therapy. Conclusions: Shortened SOF/DCV therapy, with retreatment if needed, reduces DAA use while maintaining high cure rates. D2 virologic response alone does not adequately predict SVR12 with 4 weeks treatment. Funding: Funded by the Medical Research Council (grant MR/P025064/1) and The Global Challenges Research Fund (Wellcome Trust Grant 206/296/Z/17/Z).) Clinical trial number: ISRCTN17100273

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Baseline Characteristics and Treatment Cost of Hepatitis C at Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam in Direct-Acting Antiviral Treatment Era

Cited by 7 publications

References 24 publications

Effectiveness of sofosbuvir based direct-acting antiviral regimens for chronic hepatitis C virus genotype 6 patients: Real-world experience in Vietnam

Effectiveness of sofosbuvir based direct-acting antiviral regimens for chronic hepatitis C virus genotype 6 patients: Real-world experience in Vietnam

Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for hepatitis C in a single-arm mechanistic pilot study

Efficacy of ultra-short, response-guided sofosbuvir and daclatasvir therapy for Hepatitis C: a single arm mechanistic pilot study

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