High SVR rate following retreatment of non-sustained virological responders to sofosbuvir based anti-HCV therapies regardless of RAS testing: A real-life multicenter study

Darweesh, Samar K; Elsaeed, Kadry; Omar, Heba; Raziky, Maissa El; Elakel, Wafaa; El‐Serafy, Magdy; Ismail, Sohier Ahmed; Gomaa, Ahmed; Mehrez, Mai; Kassas, Mohamed El; Abdullah, Mohamed; Mohammed, Shaker; Esmat, Gamal; Shazly, Yehia El; Doss, Wahid; Waked, Imam

doi:10.1080/17474124.2019.1629287

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…The outcome of SOF/DCV/RBV in non-responders to prior sofosbuvir-based therapy was evaluated in a large Egyptian study that included 1014 patients in which 47% were cirrhotic. Overall SVR was 90.6% with no major side effects [101].…”

Section: Sofosbuvir/daclatasvir (Dcv)mentioning

confidence: 86%

Liver Transplantation and HCV Genotype 4

Alghamdi¹,

Al–Hamoudi²

2021

Advances in Hepatology

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End-stage liver disease secondary to hepatitis C virus (HCV) infection is a major indication for liver transplantation (LT) worldwide. Previous studies have shown a negative impact of HCV on patient and graft survival leading to an inferior transplant outcome when compared to other liver transplant indications. The percentage of HCV patients infected with genotype 4 (G4) among recipients of OLT varies depending on geographic location. In the Middle East HCV-G4 infection is the most common genotype among transplant recipients. Direct antiviral agents (DAAs) have revolutionized the management of HCV infection in the pre- and post-transplant setting. Recent clinical trials have shown high sustained virologic response rates, shorter durations of treatment, and decreased adverse events when compared with the previous treatment of pegylated interferon (PEG-IFN)-based therapy. However, most of these studies were performed in HCV-G1-infected patients. Due to the low prevalence of HCV-G4 in Europe and the USA, this genotype has not been adequately studied in prospective trials evaluating treatment outcomes. The aim of this chapter is to summarize the natural history and treatment outcome of HCV-G4 in the liver transplant setting, with particular attention to new HCV therapies.

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Section: Sofosbuvir/daclatasvir (Dcv)mentioning

confidence: 86%

Liver Transplantation and HCV Genotype 4

Alghamdi¹,

Al–Hamoudi²

2021

Advances in Hepatology

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“…The model was also limited by the accuracy of the various estimated input parameters built into its framework, including assumptions about disease progression and mortality. Furthermore, the model did not account for differing SVR rates among treatment-naive vs treatment-experienced individuals, although this factor was expected to have limited consequences for the findings given the high SVR rates after retreatment . The persistent risk of reinfection after SVR was also not addressed in this model and may have resulted in some overestimation of the association between treatment strategies and HCV infection prevalence .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the model did not account for differing SVR rates among treatment-naive vs treatment-experienced individuals, although this factor was expected to have limited consequences for the findings given the high SVR rates after retreatment. 69,70 The persistent risk of reinfection after SVR was also not addressed in this model and may have resulted in some overestimation of the association between treatment strategies and HCV infection prevalence. 71 In addition, the model assumed uniform treatment initiation among all individuals with HCV infection and did not account for various barriers to treatment uptake among different risk groups, including persons who inject drugs, many of whom are not reached by health care services; however, this factor may have been partially accounted for by including treatment coverage by fibrosis level in the model.…”

Section: Limitationsmentioning

confidence: 99%

Assessment of Treatment Strategies to Achieve Hepatitis C Elimination in Canada Using a Validated Model

et al. 2020

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IMPORTANCEAchievement of the World Health Organization (WHO) target of eliminating hepatitis C virus (HCV) by 2030 will require an increase in key services, including harm reduction, HCV screening, and HCV treatment initiatives in member countries. These data are not available for Canada but are important for informing a national HCV elimination strategy. OBJECTIVE To use a decision analytical model to explore the association of different treatment strategies with HCV epidemiology and HCV-associated mortality in Canada and to assess the levels of service increase needed to meet the WHO elimination targets by 2030. DESIGN, SETTING, AND PARTICIPANTS Study participants in this decision analytical model included individuals with hepatitis C virus infection in Canada. Five HCV treatment scenarios (optimistic, very aggressive, aggressive, gradual decrease, and rapid decrease) were applied using a previously validated Markov-type mathematical model. The optimistic and very aggressive treatment scenarios modeled a sustained annual treatment of 10 200 persons and 14 000 persons, respectively, from 2018 to 2030. The aggressive, gradual decrease, and rapid decrease scenarios assessed decreases in treatment uptake from 14 000 persons to 10 000 persons per year, 12 000 persons to 8500 persons per year, and 12 000 persons to 4500 persons per year, respectively, between 2018 and 2030. MAIN OUTCOMES AND MEASURES Hepatitis C virus prevalence and HCV-associated health outcomes were assessed for each of the 5 treatment scenarios with the goal of identifying strategies to achieve HCV elimination by 2030. RESULTS An estimated mean 180 142 persons (95% CI, 122 786-196 862 persons) in Canada had chronic HCV infection at the end of 2017. The optimistic and gradual decrease scenarios estimated a decrease in HCV prevalence from 180 142 persons to 37 246 persons and 37 721 persons, respectively, by 2030. Relative to 2015, this decrease in HCV prevalence was associated with 74%, 69%, and 69% reductions in the prevalence of decompensated cirrhosis, hepatocellular carcinoma, and liver-associated mortality, respectively, leading to HCV elimination by 2030. More aggressive treatment uptake (very aggressive scenario) could result in goal achievement up to 3 years earlier than 2030, although a rapid decrease in the initiation of treatment (rapid decrease scenario) would preclude Canada from reaching the HCV elimination goal by 2030. CONCLUSIONS AND RELEVANCEThe study findings suggest that Canada could meet the WHO goals for HCV elimination by 2030 by sustaining the current national HCV treatment rate during the next decade. This target will not be achieved if treatment uptake is allowed to decrease rapidly.

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“…HEV was a coinfection among patients infected with bloodborne viral hepatitis such as HBV and HCV and enterically-transmitted pathogens such as HAV and Schistosoma. HCV and HBV were endemic in Egypt and the highest prevalence of HCV globally was reported in Egypt [66,127], although it has been recently declining due to the treatment of infected subjects with direct acting antivirals [128]. HEV/HCV coinfection was reported among different subjects, such as blood donors, pregnant women, villagers, and acute hepatitis patients [60,65,67].…”

Section: Coinfection Of Hev With Other Endemic Hepatotropic Pathogens...mentioning

confidence: 99%

Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?

Sayed

Abdelwahab

2022

Pathogens

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Though Egypt ranks among the top countries for viral hepatitis and death-related liver disease, Hepatitis E virus (HEV) is a neglected disease. Living in villages and rural communities with low sanitation, use of underground well water and contact with animals are the main risk factors for HEV infection. Domestic animals, especially ruminants and their edible products, are one source of infection. Contamination of water by either human or animal stools is the main route of infection. In addition, HEV either alone or in coinfection with other hepatotropic viruses has been recorded in Egyptian blood donors. HEV seropositivity among Egyptian villagers was 60–80%, especially in the first decade of life. Though HEV seropositivity is the highest among Egyptians, HEV infection is not routinely diagnosed in Egyptian hospitals. The initial manifestations of HEV among Egyptians is a subclinical infection, although progression to fulminant hepatic failure has been recorded. With the improvement in serological and molecular approaches and increasing research on HEV, it is becoming clear that HEV represents a threat for Egyptians and preventive measures should be considered to reduce the infection rate and possible complications.

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High SVR rate following retreatment of non-sustained virological responders to sofosbuvir based anti-HCV therapies regardless of RAS testing: A real-life multicenter study

Cited by 4 publications

References 14 publications

Liver Transplantation and HCV Genotype 4

Liver Transplantation and HCV Genotype 4

Assessment of Treatment Strategies to Achieve Hepatitis C Elimination in Canada Using a Validated Model

Is Hepatitis E Virus a Neglected or Emerging Pathogen in Egypt?

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