Efficacy of direct-acting antiviral treatment for chronic hepatitis C: A single hospital experience

Abstract

AIMTo evaluate the efficacy of direct-acting antivirals (DAAs) in Kanto Rosai Hospital.METHODSAll patients with hepatitis C virus (HCV) who underwent DAA prescription were enrolled in this study. The present study was a single center retrospective analysis using patients infected with HCV genotype 1 or 2. Resistance analysis was performed by using direct sequencing and cycleave PCR in genotype 1 patients treated with interferon (IFN)-free DAA. The primary endpoint was sustained virologic response at 12 wk after therapy (SVR12).RESULTSA total of 117 patients participated in the study, including 135 with genotype 1 and 42 with genotype 2. Of the 135 patients with genotype 1, 16 received protease inhibitor + IFN + ribavirin and all achieved SVR. Of the 119 patients who received IFN-free DAA (in different combinations), 102 achieved SVR and 9 failed (7/9 were on daclatasvir/asunaprevir and 2/9 on ledipasvir/sofosbuvir). Efficacy analysis was done only for 43 patients who received daclatasvir/asunaprevir. From this analysis, Y93 resistance-associated substitutions were significantly correlated with SVR.CONCLUSIONThe SVR rate was 98% for genotype 1 and 100% for genotype 2. However, caution is needed for HCV NS5A resistance-associated substitutions that are selected by HCV NS5A inhibitors because cerebrovascular adverse events are induced by some DAA drugs.

A complex increase in hepatitis C virus in a correctional facility: bumps in the road

“…For positive cases in the QCF, an appointment is made with the Liver Clinic Outreach Team (LCOT) for follow‐up and treatment decisions. Men who test positive for HCV are advised that there is treatment available (DAA) in the prison that cures 98% of people, with other treatments available for the remaining 2% 17 . Multiple and consecutive treatments are possible for those who are reinfected.…”

“…Men who test positive for HCV are advised that there is treatment available (DAA) in the prison that cures 98% of people, with other treatments available for the remaining 2%. 17 The LCOT also assisted in upskilling the local prison health service to provide HCV screening and treatment, resulting in improved timely access to treatment. Local prescribing within the prison assisted in greatly ramping up treatment numbers and reducing wait times to start treatment.…”

Risk of adverse outcomes following treatment with direct acting antiviral drugs in HCV infected patients with liver cirrhosis

“…HCV is a life-threatening pathogen and a worldwide health problem. It is a major cause of morbidity and mortality [ 2 ]. The high risk of HCV leads to life-threatening complications such as chronic liver disease (CLD), hepatic failure, fibrosis, hepatocellular carcinoma (HCC), liver cirrhosis and end-stage liver disease [ 3 ].…”