Treatment with Sofosbuvir/Velpatasvir of the most difficult to cure HCV-infected population

Flisiak, Robert; Zarębska-Michaluk, Dorota; Berak, Hanna; Tudrujek-Zdunek, Magdalena; Lorenc, Beata; Dobrowolska, Krystyna; Janocha‑Litwin, Justyna; Mazur, Włodzimierz; Parfieniuk-Kowerda, Anna; Jaroszewicz, Jerzy

doi:10.20452/pamw.16644

Polish Archives of Internal Medicine

2024

DOI: 10.20452/pamw.16644

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Treatment with Sofosbuvir/Velpatasvir of the most difficult to cure HCV-infected population

Robert Flisiak,

Dorota Zarębska-Michaluk,

Hanna Berak

et al.

Abstract: difficult -to -cure HCV -infected patients 1 a dramatic increase in effectiveness, labeling some patient populations as difficult -to -treat no longer seems valid. This change was one of the factors that made it possible to achieve the goal set by the World Health Organization INTROduCTION A revolution in the treatment of chronic hepatitis C virus (HCV) infection that took place in the last decade thanks to the introduction of direct -acting antivirals (DAAs) improved cure rates to over 95%. 1 With such

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Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices

Brzdęk,

Zarębska-Michaluk,

Kukla

et al. 2024

Pharmacol. Rep

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Background Hepatitis C virus (HCV) infection affects 50 million people worldwide with around 242,000 deaths annually, mainly due to complications such as cirrhosis and hepatocellular carcinoma (HCC). Portal hypertension (PH) caused by cirrhosis leads to severe consequences, including esophageal varices (EV). This study aimed to evaluate the effectiveness and safety of direct-acting antiviral (DAA) treatment in patients with and without EV. Methods This retrospective analysis involved consecutive HCV-infected adults undergoing DAA therapy at 22 Polish hepatology centers from July 1, 2015, to December 31, 2022. Patients with cirrhosis were categorized based on the presence of EV diagnosed by gastroscopy. Treatment effectiveness was measured by sustained virologic response (SVR), with safety outcomes monitored for 12 weeks post-treatment. Results A population of 3393 HCV-infected patients with cirrhosis was divided into groups with (A, n = 976) and without (B, n = 2417) EV. Group A showed a significantly higher prevalence of comorbidities and concomitant medications. Genotype (GT)1b infections predominated in both groups, and GT3 infections were more common in the EV group. Group A exhibited more severe liver disease, and higher rates of decompensation, HCC, and HBV co-infection. SVR was significantly higher in group B (91.5% vs. 96.3%, p < 0.0001). Male gender, GT3, EV presence, and Child-Pugh grade B were identified as independent negative SVR predictors. Group A had a worse safety profile, with notably higher adverse event incidence and mortality. Conclusions DAA therapies are highly effective and well tolerated in patients with cirrhosis, but EV presence predicts poorer virologic responses.

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Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices

Brzdęk,

Zarębska-Michaluk,

Kukla

et al. 2024

Pharmacol. Rep

View full text Add to dashboard Cite

show abstract

Revolutionizing hepatitis C treatment: next-gen direct-acting antivirals

Dobrowolska,

Brzdęk,

Rzymski

et al. 2024

Expert Opinion on Pharmacotherapy

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Treatment with Sofosbuvir/Velpatasvir of the most difficult to cure HCV-infected population

Cited by 2 publications

References 16 publications

Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices

Real-world experience with direct-acting antiviral therapy in HCV-infected patients with cirrhosis and esophageal varices

Revolutionizing hepatitis C treatment: next-gen direct-acting antivirals

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