Treatment and re-treatment results of HCV patients in the DAA era

Abstract

Background Re-treatment in patients with a chronic hepatitis C virus (HCV) infection and a previous failure to direct-acting antiviral (DAA) treatment remains a challenge. Therefore, we investigated the success rate of treatment and re-treatment regimens used at our center from October 2011 to March 2018. Methods A retrospective analysis of DAA-based HCV therapies of 1096 patients was conducted. Factors associated with a virological relapse were identified by univariable and multivariable logistic regression, treatment success of the re-treatment regimens was evaluated by an analysis of sustained virological response (SVR) rates in patients with a documented followup 12 weeks after the end of treatment. Results Of 1096 patients treated with DAA-based regimens, 91 patients (8%) were lost to follow-up, 892 of the remaining 1005 patients (89%) achieved an SVR12. Most patients (65/113, 58%) who experienced a virological relapse received an interferon-based DAA regimen. SVR rates were comparable in special cohorts like liver transplant recipients (53/61, 87%) and people with a human immunodeficiency virus (HIV) coinfection (41/45, 91%). On multivariable analysis, interferon-based DAA therapy was associated with treatment failure (odds ratio 0.111, 95%-confidence interval 0.054-0.218) among others. One hundred seventeen patients with multiple DAA treatment courses were identified, of which 97 patients (83%) experienced a single relapse, but further relapses after two (18/117, 15%) or even three (2/ 117, 2%) treatment courses were also observed. Eighty-two of 96 (85%) re-treatment attempts with all-oral DAA regimens were successful after an initial treatment failure.

Management of Hepatitis C Virus Genotype 4 Treatment Failure: A Real-World Single Center Experience

“…In this regard, similar results were reported by the few relevant real world studies (85% Dietz et al [7] & Piecha et al [15]. and 86% by Zarębska-Michaluk et al [3].…”

“…It is noteworthy to mention that, lack of RAS testing before initiation of retreatment did not seem to affect retreatment results in this study (88% SVR rate), an observation that has also been reported by other real-world studies [15].…”

Effectiveness of Direct-Acting Antivirals in Treatment of Elderly Egyptian Chronic Hepatitis C Patients

“…Similar to our findings, several studies showed that the SOF/DCV regimen is effective for the treatment of CHC. Babatin et al reported SVR 100% in all studied GT4 patients treated for 12 weeks with either SOF/SIM ± RBV (group 1) or SOF/DCV ± RBV (group 2) [34]. Another study showed a SVR12 rate of 96.67% in treating non-cirrhotic GT4 patients with SOF/DCV [35].…”

Epidemiología de la infección por el virus de la hepatitis C en Colombia

“…Este resultado señala la necesidad de realizar estudios para caracterizar los factores de riesgo de estos pacientes y documentar la introducción de este genotipo prevalente en Egipto. Además, la genotipificación es indispensable en casos de VHC con factores de riesgo, dada la posibilidad de reinfección luego del tratamiento con AAD ( 68 , 69 ).…”