Treatment of Chronic HCV Infection with the New Direct Acting Antivirals (DAA): First Report of a Real World Experience in Southern Brazil

Cheinquer, Hugo; Sette, H; Fh, Wolff; A, de Araujo; Coelho-Borges, Silvia; Srp, Soares; Barros,

doi:10.5604/01.3001.0010.2717

Cited by 39 publications

(32 citation statements)

References 25 publications

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“…In a highly representative population of patients infected with HCV throughout the country and treated with the same therapeutic regimen, the overall SVR rates were higher than 95% [ 20 ]. In a real-world cohort from three hepatology centers from southern Brazil, SVR was achieved in 95% of patients treated with second-generation DAAs [ 21 ]. In Spain, rates of 96.8% and 95.8% were found in two cohorts of individuals infected with HCV with genotype 1 treated by second-generation DAAs [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil

et al. 2020

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Hepatitis virus infection is a major public health problem worldwide. Currently, Brazil has almost 700,000 cases. The Brazilian Unified Health System (SUS) provides therapeutic regimens for people infected with hepatitis C virus (HCV). We determined the clinical, laboratory, epidemiologic, and geospatial characteristics of patients infected with HCV treated with second-generation direct-action antivirals (DAAs) in a hospital reference center in São Paulo state, Brazil, using data from file records. A map was constructed using a geographic information system. From 2015 to 2018, 197 individuals received second-generation DAAs (mean age, 57.68 ± 1.36 years; interquartile range, 56.22–59.14 years; 58.9% male; 41.1% female). Genotypes 1a and 1b accounted for 75.7% of cases and the prevalent therapeutic regimen was sofosbuvir/simeprevir. Sustained viral response accounted for 98.9% and the METAVIR score F3/F4 for 50.8%. Increased alanine transferase was significantly correlated with an increase in α-fetoproteins (p = 0.01), and severe necro-inflammatory activity (p = 0.001). Associated comorbidities were found in 71.6%, mainly coronary artery and gastrointestinal disorders. The cumulative incidence in the region was 2.6 per 10,000 inhabitants. Our data highlight the role of reference hospitals in Brazil’s public health system in the treatment of HCV. Low incidence rates demonstrated the fragility of municipalities in the active search for patients.

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Section: Discussionmentioning

confidence: 99%

Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil

et al. 2020

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“…Finally, screening and full-text assessment resulted in 20 included studies (14 manuscripts and 6 conference abstracts) that reported on SVR12 by DAAs in 7,393 individuals from South American countries ( Figure 1). [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] A total of 16 studies were published in English, two in Spanish 40,44 and two in Portuguese. 29,33 In addition, included studies were performed in Sofosbuvir/Simeprevir ± Ribavirin (SOF/SIM ± RBV), Sofosbuvir/ Ledipasvir (SOF/LDV) or Ombitasvir/Paritaprevir/Ritonavir + Dasa buvir ± Ribavirin (OBV/PTV/r/DSV ± RBV).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Effectiveness of direct‐acting agents for chronic hepatitis C treatment in South America: A systematic review and meta‐analysis

Filho

Piedade

Castro

et al. 2020

Journal of Viral Hepatitis

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The effectiveness of direct-acting agents (DAAs) for hepatitis C treatment in limited-resource settings remains unclear. We estimated the pooled sustained virological response rates of DAA therapy in South America. We searched online databases for studies that reported 12-week sustained virological response (SVR12) to hepatitis C virus (HCV) treatment in individuals living in South America. Pooled SVR12 in intention-to-treat (ITT) and per-protocol were estimated. Additionally, using all studies with available data, the pooled relative risk (RR) of SVR12 using a randomeffects model (DerSimonian-Laird) was estimated to compare effectiveness of DAAs in patients with or without cirrhosis, HIV co-infection or previous HCV therapy. Heterogeneity was assessed using the I 2 statistics. We identified 20 studies [14 manuscripts and 6 conference abstracts] comprising 7393 individuals from five countries [Brazil (n = 11), Argentina (n = 4), Chile (n = 1), Colombia (n = 1) and Peru (n = 1)] and two South-American collaborations. The pooled overall SVR12 rates [95% confidence interval (CI)] were 92.6% [90.2-94.7] and 95.5% [94.3-96.6] by ITT (11 studies; n = 4,153; I 2 = 84.2%) and per-protocol analysis (15 studies; n = 4,833; I 2 = 64.5%), respectively. The RR of SVR12 was similar in patients with or without HIV co-infection [4 studies; RR = 1.03 (0.99-1.07)] and those naive compared with treatment experimented-individuals [9 studies; RR = 1.01 (1.00-1.03)], but significantly higher in patients without cirrhosis compared with those with cirrhosis [11 studies; RR = 1.04

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“…In Brazil, DAAs were incorporated by the Ministry of Health for the treatment of hepatitis C under the Unified Health System (SUS) since 2015 (Ministério da Saúde, 2018). Unfortunately, there is little data about the efficacy of DAAs in Brazil, with some information found in the study by Sette Jr et al (2017).…”

Section: Introductionmentioning

confidence: 99%

Resistance mutations of NS3 and NS5b in treatment-naïve patients infected with hepatitis C virus in Santa Catarina and Rio Grande do Sul states, Brazil

Andrade

Rocha²,

Fontana-Maurell³

et al. 2020

Genet. Mol. Biol.

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Hepatitis C virus (HCV) infection is a worldwide health problem. Nowadays, direct-acting antiviral agents (DAAs) are the main treatment for HCV; however, the high level of virus variability leads to the development of resistance-associated variants (RAVs). Thus, assessing RAVs in infected patients is important for monitoring treatment efficacy. The aim of our study was to investigate the presence of naturally occurring resistance mutations in HCV NS3 and NS5 regions in treatment-naïve patients. Ninety-six anti-HCV positive serum samples from blood donors at the Center of Hematology and Hemotherapy of Santa Catarina State (HEMOSC) were collected retrospectively in 2013 and evaluated in this study. HCV 1a (37.9%), 1b (25.3%), and 3a (36.8%) subtypes were found. The frequency of patients with RAVs in our study was 6.9%. The HCV NS5b sequencing reveled 1 sample with L320F mutation and 4 samples with the C316N/R polymorphism. The analysis of the NS3 region revealed the D168A/G/T (3.45%), S122G (1.15%), and V55A (2.3%) mutations. All samples from genotype 3a (36.8%) presented the V170 I/V non-synonymous mutation. In conclusion, we have shown that mutations in NS3 and NS5b genes are present in Brazilian isolates from therapy-naïve HCV patients.

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Treatment of Chronic HCV Infection with the New Direct Acting Antivirals (DAA): First Report of a Real World Experience in Southern Brazil

Abstract: Real world experience with DAA therapy in Southern Brazil showed a high rate of SVR and excellent tolerability. Failure to achieve SVR was mainly observed among patients with at least one negative predictor of response: cirrhosis and/or genotypes 1a or 3.

Cited by 39 publications

References 25 publications

Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil

Clinical, Epidemiological, and Geospatial Characteristics of Patients Infected with Hepatitis C Virus Treated with Second-Generation Direct-Action Antivirals in a Reference Center in a Mesoregion of São Paulo State, Brazil

Effectiveness of direct‐acting agents for chronic hepatitis C treatment in South America: A systematic review and meta‐analysis

Resistance mutations of NS3 and NS5b in treatment-naïve patients infected with hepatitis C virus in Santa Catarina and Rio Grande do Sul states, Brazil

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