Treatment of hepatitis C virus infection with direct-acting antiviral agent-based regimens in Iranian patients with hereditary bleeding disorders

Abstract

Background Chronic hepatitis C (CHC) is one of the most important comorbidities in patients with hereditary bleeding disorders (HBD). The present study aimed at evaluating the effectiveness of direct-acting antiviral agent (DAA)-based interferon-free HCV antiviral regimens in patients with HBD. Patients and methods The present study was performed on the patients with HBD and CHC between 2015 and 2019. Sofosbuvir-based interferon-free regimens with or without ribavirin were prescribed to treat HCV infection. The main endpoint of the study was to determine the sustained virologic response (SVR), assessed 12 weeks after the completion of treatment. Results A total of 147 patients with a mean age of 41.1 years were enrolled in the study; 4.1% of them were co-infected with HIV, 25.2% had cirrhosis, and 76.9% of them were diagnosed with hemophilia A. HCV genotype-1 includes the largest number (68.1%) of patients. 46.3% of patients were treatment-naïve and others had a treatment history with interferon-based regimens. Out of 147 patients, 15 patients were lost to follow-up during treatment or for SVR evaluation or discontinued treatment. 132 subjects completed treatment and were evaluated for SVR, 12 weeks after the completion of treatment. All of the patients achieved SVR 12 (SVR rate: 100%, 95% CI 97.2–100%). Conclusion Hepatitis C DAA-based regimens are the effective treatments for CHC in patients with HBD, regardless of the treatment modifiers such as previous treatment experience, cirrhosis, HIV co-infection, and HCV genotype.

Trends in the Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Iranian Patients with Hereditary Bleeding Disorders

“…They have been regularly screened for HCV infection and directed to treatment; however, the first antiviral therapies used for the treatment of HCV in HBDs in Iran were interferon (IFN)-based treatments accompanied by no more than a 50% chance of curing the patient [30]. Hopefully, the anti-HCV treatments introduced recently are IFN-free with more than a 95% chance of achieving a sustained virologic response in patients with HBDs [31]. With the availability of new diagnostic and therapeutic modalities, the World Health Organization (WHO) has urged to plan for the elimination of HCV and HBV and 90-90-90 targets for the control of HIV by 2030 [32,33].…”

Hepatitis C Virus Infections in Patients with Hemophilia: Links, Risks and Management

“…Of the 132 patients who completed treatment and were evaluated for SVR12, all achieved SVR. 70 A retrospective, single-center study including 26 haemophilia patients with CHC infection was carried out in the Clinical Center of Vojvodina, in the northern region of Serbia. Nine of them received DAA regimens with an SVR rate of 100%.…”

Non-Invasive Diagnosis of Liver Fibrosis in Chronic Hepatitis C using Mathematical Modeling and Simulation

“…In the case of infectious and epidemic disease modeling, ABM has been increasingly used to capture the transmission of a virus among agents with distinct and heterogeneous behavior and characteristics (e.g., age and underlying condition) [38][39][40][41]. ABM has also been used for simulating the transmission of HCV through the interaction of infected and non-infected agents [42], HCV epidemic forecasting among drug injection users [43], evaluating the effectiveness of different treatments in HCV patients [44,45], and optimizing HCV treatments to achieve the goal of eliminating HCV in the future [46].…”