Sustained virological response after treatment in patients with chronic hepatitis C infection - a five year follow up

Rahman, MM; Ahmed, Dewan Saifuddin; Masud, Hasan; Parveen, S; Chowdhury,; Barua, Rajib; Ishaque, SM

doi:10.3329/bmrcb.v39i1.15791

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…With regard to the clinical relevance of patients with positive OCI, all positive OCI cases were cirrhotic with a significant fibrosis score (F3 or F4) and also abnormal liver function tests, especially raised ALT prior to treatment. These findings were also reported in other studies of Rahman et al and Sood et al, which found a definite percentage of OCI that occurs more often in patients with overt cirrhosis 32,33. Elmasry et al examined the occurrence of OCI in HCV-infected liver transplant recipients who achieved SVR with recent DAAs and found an altered aminotransferase levels in 11% of their patients 34.…”

Section: Discussionsupporting

confidence: 73%

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Mekky¹,

Sayed²,

Abdelmalek³

et al. 2019

IDR

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BackgroundOccult hepatitis C virus (HCV) infection (OCI) is characterized by the detection of HCV-RNA in non-serum reservoirs, such as peripheral blood mononuclear cells (PBMCs) and/or hepatocytes with undetectable HCV-RNA or antibodies in the serum. In this study, we tried to evaluate the prevalence and possible predictors of OCI in patients who achieved sustained virologic response (SVR) post sofosbuvir/daclatasvir (SOF/DCV) therapy.Patients and methodsA cross-sectional multicenter study was designed to enroll 1,280 HCV-infected patients who received SOF (400 mg) plus DCV (60 mg) once daily ± ribavirin regimen for 12 weeks and achieved SVR 12 weeks post treatment. They were randomly recruited from three dedicated Egyptian centers for management of HCV. Real-time PCR was performed to detect HCV-RNA in serum and PBMCs and to evaluate the different risk factors pertaining to the existence of OCI.ResultsHCV-RNA was detected in PBMCs of 50 (3.9%) of them. All OCI cases exhibited significant fibrosis score and raised pre-treatment alanine aminotransferase (ALT) levels. Logistic regression analysis comparing OCI with non-OCI revealed that high pre-treatment viral load, raised ALT, advanced fibrosis score, prolonged prothrombin time, low albumin, Child B score, antiviral experienced patients, and raised bilirubin are the most significant predictor for the possibility of OCI presence with Odds Ratio as 7.03, 5.13, 4.4, 2.68, 2.52, 1.9, 1.5, and 1.2, respectively.ConclusionIn spite of its remote possibility, OCI post SOF/DCV therapy may be present in some cases, and this may entail a re-auditing for the definition of SVR by dual testing in both serum and PBMCs.

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Section: Discussionsupporting

confidence: 73%

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Mekky¹,

Sayed²,

Abdelmalek³

et al. 2019

IDR

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“…In adults, durability of SVR 5 years after completing PegIFN treatment has been observed to be >99% [4] and cirrhosis appears to be a risk factor for long-term relapse [5].…”

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confidence: 99%

Durability of Response in Children Treated With Pegylated Interferon alfa‐2a ± Ribavirin for Chronic Hepatitis C

Schwarz

Molleston

Jonas

et al. 2016

J. pediatr. gastroenterol. nutr.

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Objectives:No long-term data have been published on the durability of response following pegylated interferon (PegIFN) treatment in children with chronic hepatitis C (CHC). This prospective, multi-center, long-term follow-up (LTFU) study aimed to assess long-term durability of sustained virological response (SVR), long-term safety and tolerability, and the association between IL28B genotype and treatment response, in children previously treated with PegIFN alfa-2a ± ribavirin (RBV) in the PEDS-C trial.Methods: Ninety-three patients were assessed for enrollment and 38 enrolled in the study.Patients attended two study visits: 5 (mean 5.6; range 4.1 -6.6) and 6 (6.6; 5.1 -7.7) years after treatment cessation. Standardized medical history, physical examination and laboratory testing were done at these visits. Reminder telephone calls were conducted at 4 and 8 months after the initial visit. Results:The LTFU cohort was representative of the original PEDS-C cohort as both baseline and treatment characteristics were comparable. Of the 38 participants, 21 achieved SVR (responders) during the PEDS-C trial and 17 had not (non-responders). All 21 responders maintained undetectable HCV RNA during the LTFU (4.4 -7.0 years after achieving SVR) in contrast to the non-responders who demonstrated persistent viremia. IL28B CC genotype was associated with SVR (67%, vs. 30% in non-CC, p=0.028). Conclusion:Long-term durability of SVR is excellent following PegIFN alfa-2a treatment in children with CHC; SVR is higher in those with IL28B CC vs non-CC.Keywords: pediatric viral hepatitis; antiviral therapy; PEDS C study; long term follow up Copyright © ESPGHAN and NASPGHAN. All rights reserved.

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“…Rahman et al [ 118 ] have reported that a SVR to current IFN treatment regimens is durable in most patients, but not all and that late relapses can occur during long-term followup. Importantly, they reported that this finding occurs more often in patients with cirrhosis.…”

Section: Clinical Relevancementioning

confidence: 99%

A New Twist to a Chronic HCV Infection: Occult Hepatitis C

Attar

Thiel²

2015

Gastroenterology Research and Practice

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Background. The prevalence of occult hepatitis C infection (OCI) in the population of HCV-RNA negative but anti-HCV positive individuals is presently unknown. OCI may be responsible for clinically overt recurrent disease following an apparent sustained viral response (SVR) weeks to years later. Purpose. To review the available current literature regarding OCI, prevalence, pathogenic mechanisms, clinical characteristics, and future directions. Data Sources. Searching MEDLINE, article references, and national and international meeting abstracts for the diagnosis of OCI (1990–2014). Data Synthesis. The long-term followup of individuals with an OCI suggests that the infection can be transient with the loss of detectable HCV-RNA in PPBMCs after 12–18 months or alternatively exist intermittently and potentially long term. The ultimate outcome of HCV infection is decided by interplay between host immune responses, antiviral therapies, and the various well-identified viral evasion mechanisms as well as the presence of HCV infection within extrahepatic tissues. Conclusion. The currently widely held assumption of a HCV-cure in individuals having had “SVR” after 8–12 weeks of a course of DAA therapy as recently defined may not be entirely valid. Careful longitudinal followup utilizing highly sensitive assays and unique approaches to viral isolation are needed.

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Sustained virological response after treatment in patients with chronic hepatitis C infection - a five year follow up

Cited by 11 publications

References 15 publications

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

<p>Prevalence and predictors of occult hepatitis C virus infection among Egyptian patients who achieved sustained virologic response to sofosbuvir/daclatasvir therapy: a multi-center study</p>

Durability of Response in Children Treated With Pegylated Interferon alfa‐2a ± Ribavirin for Chronic Hepatitis C

A New Twist to a Chronic HCV Infection: Occult Hepatitis C

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