Impact of direct-acting antivirals for HCV on mortality in a large population-based cohort study

Janjua, Naveed Z.; Wong, Stanley; Abdia, Younathan; Jeong, Dahn; Buller-Taylor, Terri; Adu, Prince; Samji, Hasina; Wilton, James; Pearce, Margo; Butt, Zahid A; Yu, Amanda; Binka, Mawuena; Bartlett, Sofia; Alvarez, Maria; Krajden, Mel

doi:10.1016/j.jhep.2021.05.028

Cited by 44 publications

(70 citation statements)

References 35 publications

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“…19 Recently, great progress has been made in the anti-viral treatment of hepatitis B and C viruses. [45][46][47] MAFLD allows investigation of the effects of fatty liver on life-threatening events and the prognosis of such patients.…”

Section: Dual Etiology Of Mafld and Other Liver Diseasesmentioning

confidence: 99%

“…Therefore, patients with MAFLD and other liver diseases are defined as having dual (or multiple) etiologies of fatty liver disease 19 . Recently, great progress has been made in the anti‐viral treatment of hepatitis B and C viruses 45–47 . MAFLD allows investigation of the effects of fatty liver on life‐threatening events and the prognosis of such patients.…”

Section: Dual Etiology Of Mafld and Other Liver Diseasesmentioning

confidence: 99%

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MAFLD: Renovation of clinical practice and disease awareness of fatty liver

Kawaguchi

Tsutsumi

Nakano

et al. 2021

Hepatology Research

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Recently, international expert panels have proposed a new definition of fatty liver: metabolic dysfunction‐associated fatty liver disease (MAFLD). MAFLD is not just a simple renaming of non‐alcoholic fatty liver disease (NAFLD). The unique feature of MAFLD is the inclusion of metabolic dysfunctions, which are high‐risk factors for events. In addition, MAFLD is independent of alcohol intake and the co‐existing causes of liver disease. This new concept of MAFLD may have a widespread impact on patients, medical doctors, medical staff, and various stakeholders regarding fatty liver. Thus, MAFLD may renovate clinical practice and disease awareness of fatty liver. In this review, we introduce the definition of and rationale for MAFLD. We further describe representative cases showing how the diagnostic processes differ between MAFLD and NAFLD. We also summarize recent studies comparing MAFLD with NAFLD and discuss the impact of MAFLD on clinical trials, Japanese populations, and disease awareness.

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Section: Dual Etiology Of Mafld and Other Liver Diseasesmentioning

confidence: 99%

Section: Dual Etiology Of Mafld and Other Liver Diseasesmentioning

confidence: 99%

MAFLD: Renovation of clinical practice and disease awareness of fatty liver

Kawaguchi

Tsutsumi

Nakano

et al. 2021

Hepatology Research

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“…However, it is expected that prolonged replication in the same liver may favor fitness increase of the resident HCV. This emphasizes the success of current DAA-based treatments of chronic HCV infection, which achieve sustained virological responses of around 95% (Janjua et al, 2021 ). The process required for the approval of new antiviral agents (even if they are a modified form of a previously licensed agent or one investigated from drug repositioning) is generally lengthy and costly.…”

Section: Discussionmentioning

confidence: 98%

“…The administration of direct-acting antiviral (DAA) agents has been highly successful for the control of chronic hepatitis C virus (HCV) infections, with sustained virological responses of around 95% (Janjua et al, 2021 ). Selection of RAS is responsible for a large proportion of HCV treatment failures (Di Maio et al, 2017 , 2021 ; Kai et al, 2017 ; Ceccherini-Silberstein et al, 2018 ; Dietz et al, 2018 ; Perpinan et al, 2018 ; Sorbo et al, 2018 ; Lombardi et al, 2019 ; Chen et al, 2020 ; Malandris et al, 2021 ; Sarrazin, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy decrease of antiviral agents when administered to ongoing hepatitis C virus infections in cell culture

et al. 2022

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We report a quantification of the decrease of effectiveness of antiviral agents directed to hepatitis C virus, when the agents are added during an ongoing infection in cell culture vs. when they are added at the beginning of the infection. Major determinants of the decrease of inhibitory activity are the time post-infection of inhibitor administration and viral replicative fitness. The efficacy decrease has been documented with antiviral assays involving the combination of the direct-acting antiviral agents, daclatasvir and sofosbuvir, and with the combination of the lethal mutagens, favipiravir and ribavirin. The results suggest that strict antiviral effectiveness assays in preclinical trials may involve the use of high fitness viral populations and the delayed administration of the agents, relative to infection onset.

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“…28 Janjua et al showed SVR was also associated with a significant reduction in the risk of all-cause, liver-and drug-related mortality. 31 Meta-regression. Considering the great heterogeneity in our meta-analysis, meta-regression was performed.…”

Section: Subgroup Analyses Of Recurrence and Overall Survivalmentioning

confidence: 99%

Clinical benefits of direct‐acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta‐analysis

Liu

Yang

Dong

et al. 2022

J of Gastro and Hepatol

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Background and Aim:The purpose of the present study was to evaluate the effect of direct-acting antivirals (DAAs) therapy on the clinical outcomes of hepatitis C virus (HCV) patients with hepatocellular carcinoma (HCC). Methods: We searched multiple electronic databases from database inception to June 14, 2021. Meta-analyses were performed separately for HCC recurrence and overall survival (OS). Results: A total of 23 studies were identified for the primary analysis. Compared with no intervention, pooled data showed significant benefit from DAAs therapy in reducing recurrence (adjusted HR = 0.55, 95% CI 0.41-0.74, P < 0.001; I 2 = 66.6%, P < 0.001) and improving OS (adjusted HR = 0.36, 95% CI 0.16-0.83, P = 0.017; I 2 = 90.7%, P < 0.001) of HCV-related HCC patients. Compared with non-responders, patients with sustained virologic response (SVR) had greater benefit from DAAs therapy in reducing recurrence (HR = 0.37, 95% CI 0.16-0.84, P = 0.017; I 2 = 58.8%, P = 0.088) and improving OS (HR = 0.17; 95% CI 0.06-0.50; P = 0.001; I 2 = 56.4%, P = 0.130). Though DAAs did not show significant advantages over IFN in reducing recurrence (adjusted HR = 0.96, 95% CI 0.72-1.28, P = 0.784; I 2 = 0.0%, P = 0.805), there seems to be a trend toward OS benefit from DAAs therapy (adjusted HR = 0.11, 95% CI 0.01-1.19, P = 0.059). Conclusion: DAAs therapy can prevent recurrence and improve OS of HCV-related HCC patients, especially for patients with SVR. Further prospective randomized controlled trial is warranted to validate these results.

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Impact of direct-acting antivirals for HCV on mortality in a large population-based cohort study

Cited by 44 publications

References 35 publications

MAFLD: Renovation of clinical practice and disease awareness of fatty liver

MAFLD: Renovation of clinical practice and disease awareness of fatty liver

Efficacy decrease of antiviral agents when administered to ongoing hepatitis C virus infections in cell culture

Clinical benefits of direct‐acting antivirals therapy in hepatitis C virus patients with hepatocellular carcinoma: A systematic review and meta‐analysis

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