Sofosbuvir and ledipasvir are associated with high sustained virologic response and improvement of health‐related quality of life in East Asian patients with hepatitis C virus infection

Aeolian prokaryotic communities (APC) are important components of bioaerosols that are transported freely or attached to dust particles suspended in the atmosphere. Terrestrial and marine ecosystems are known to release and receive significant prokaryote loads into and from the surrounded atmospheric air. However, compared to terrestrial systems, there is a lack of microbial characterization of atmospheric dust over marine systems, such as the Red Sea, which receives significant terrestrial dust loads and is centrally located within the Global Dust Belt. Prokaryotic communities are likely to be particularly important in the Global Dust Belt, the area between the west coast of North Africa and Central Asia that supports the highest dust fluxes on the planet. Here we characterize the diversity and richness of the APC over the Red Sea ecosystem, the only sea fully contained within the Global Dust Belt. MiSeq sequencing was used to target 16S ribosomal DNA of two hundred and forty aeolian dust samples. These samples were collected at ∼7.5 m high above the sea level at coastal and offshore sampling sites over a 2-year period (2015–2017). The sequencing outcomes revealed that the APC in the atmospheric dust is dominated by Proteobacteria (42.69%), Firmicutes (41.11%), Actinobacteria, (7.69%), and Bacteroidetes (3.49%). The dust-associated prokaryotes were transported from different geographical sources and found to be more diverse than prokaryotic communities of the Red Sea surface water. Marine and soil originated prokaryotes were detected in APC. Hence, depending on the season, these groups may have traveled from other distant sources during storm events in the Red Sea region, where the APC structure is influenced by the origin and the concentration of aeolian dust particles. Accordingly, further studies of the impact of atmospheric organic aerosols on the recipient environments are required.

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“…Differences between environmental variables and factors were tested using analysis of variance (Younossi et al, 2018) and t-test.…”

Section: Statistical Analysesmentioning

confidence: 99%

Aeolian Prokaryotic Communities of the Global Dust Belt Over the Red Sea

et al. 2020

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“…Because IFN-free DAA treatments were associated with low rates of adverse events and short duration of treatment in comparison to IFN-based therapy, IFN-free DAA treatments provided SVR rate >95%, as observed in many studies [6][7][8] . In addition, SVR achieved by IFN-free DAA treatment improved health-related quality of life in patients with chronic HCV infection 9) . Furthermore, SVR achieved by IFN-free DAA treatment suppressed recurrence of HCC and improved overall survival 10) .…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection

et al. 2020

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Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in "rural" regions. Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan. Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events. Conclusion: G/P therapy is effective and safe for old-aged patients.

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“…With approximately 70 million infected individuals worldwide, chronic hepatitis C virus (HCV) infection remains a major global health problem resulting in significant morbidity and mortality . The ultimate goal of therapy is to achieve sustained HCV eradication which is associated with reduced liver inflammation, fibrosis progression, increased quality of life and overall survival . Elderly patients are disproportionally affected by HCV and are more likely to suffer from advanced liver disease and its complications compared to younger patients …”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of direct‐acting antivirals for hepatitis C in the elderly: A systematic review and meta‐analysis

Mücke

Herrmann

Mücke

et al. 2019

Liver International

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Background&Aims Since the introduction of direct‐acting antivirals (DAAs) several studies have reported high efficacy and safety in Hepatitis C infected patients, even in those earlier considered difficult‐to‐treat. We aimed to assess the efficacy and safety of DAA therapy in elderly patients. Methods The PubMed MEDLINE, Embase and Cochrane databases were searched through July 2018. Two independent researchers extracted data and assessed the quality and risk of bias. Risk ratios (RRs) were pooled using random effects models. The primary outcome was efficacy of DAA therapy assessed by the RR for non‐sustained virologic response (SVR) among patients aged <65 vs ≥65 years. Results Overall, we identified 63 studies including 34 082 patients treated with different DAAs. Risk for non‐SVR was comparable in patients <65 and ≥65 years of age (RR 1.00, 95% CI 0.86‐1.15; P = 0.979) and even lower in a subgroup analysis of cirrhotic patients ≥65 years of age (RR 0.59, 95% CI 0.35‐0.99, P = 0.044). Risk for non‐SVR was similar between age groups in all other subgroup analyses. Elderly patients had a significantly increased risk of adverse events (AEs) (RR 1.30, 95% CI 1.11‐1.52, P = 0.001), but not for serious adverse events (P = 0.43) or treatment discontinuation (P = 0.15). Risk for anaemia if treated with additional ribavirin was 2.84 (95% CI 1.73‐4.66, P < 0.001) in elderly patients compared to patients <65 years. Conclusion Our results show that DAAs are highly effective and safe in elderly patients. Ribavirin should be avoided in the elderly as more AEs and particularly anaemia is observed. Further cost‐effectiveness analyses are needed to evaluate the socio‐economic benefit of treating elderly people without advanced liver disease.

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Sofosbuvir and ledipasvir are associated with high sustained virologic response and improvement of health‐related quality of life in East Asian patients with hepatitis C virus infection

Cited by 15 publications

References 35 publications

Aeolian Prokaryotic Communities of the Global Dust Belt Over the Red Sea

Aeolian Prokaryotic Communities of the Global Dust Belt Over the Red Sea

Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection

Efficacy and safety of direct‐acting antivirals for hepatitis C in the elderly: A systematic review and meta‐analysis

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