scholarly journals Clinical relevance of detectable hepatitis C virus RNA in the context of direct-acting antivirals

Hepatology ◽  
2013 ◽  
Vol 57 (2) ◽  
pp. 855-856
Author(s):  
Kathleen O'sullivan ◽  
John Levis ◽  
Kevin Hegarty ◽  
Orla Crosbie ◽  
Elizabeth Kenny-Walsh ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Clinical Relevance ◽  
Direct Acting Antivirals ◽  
Hepatitis C Virus Rna ◽  
Virus Rna ◽  
Direct Acting

Liver Fibrosis and Body Mass Index Predict Hepatocarcinogenesis following Eradication of Hepatitis C Virus RNA by Direct-Acting Antivirals

Oncology ◽  
2016 ◽  
Vol 91 (6) ◽  
pp. 341-347 ◽  
Author(s):  
Norio Akuta ◽  
Masahiro Kobayashi ◽  
Fumitaka Suzuki ◽  
Hitomi Sezaki ◽  
Shunichiro Fujiyama ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Body Mass ◽  
Direct Acting Antivirals ◽  
Hepatitis C Virus Rna ◽  
Virus Rna ◽  
Direct Acting

Immunosuppressive and antiviral treatment of hepatitis C virus–associated glomerular disease: A long-term follow-up

2018 ◽  
Vol 41 (6) ◽  
pp. 306-318 ◽  
Author(s):  
Fabrizio Fabrizi ◽  
Alessio Aghemo ◽  
Pietro Lampertico ◽  
Mirella Fraquelli ◽  
Donata Cresseri ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Immunosuppressive Agents ◽  
Sustained Viral Response ◽  
Glomerular Disease ◽  
Direct Acting Antivirals ◽  
Viral Response ◽  
Virus Rna ◽  
Direct Acting

Background: The evidence in the medical literature on the treatment of hepatitis C virus–associated glomerular disease is extremely limited. The advent of nonconventional immunosuppressive agents and direct-acting antivirals promises high efficacy and safety. Aims: We conducted an open-label, single-arm clinical study to examine the efficacy and safety of a combined approach for hepatitis C virus–associated glomerular disease. Methods: In the first phase of the study, patients with hepatitis C virus–associated glomerular disease received interferon-based antiviral therapy and immunosuppressive agents; since 2013, interferon-free antiviral therapy was adopted and novel immunosuppressants (including B-cell depleting agents and mycophenolate mofetil) or immunomodulators (ribavirin) were choiced. Virological and clinical responses were evaluated over a long observation period (median follow-up of 60 weeks and 46.5 months after the end of treatment with interferon and direct-acting antiviral agents, respectively). Results: We enrolled 25 consecutive patients with hepatitis C virus–associated glomerular disease, 8 being liver transplant recipients for hepatitis C. A total of 13 patients received therapy with direct-acting antivirals and experienced sustained viral response (serum hepatitis C virus RNA <12 IU/mL, 12 weeks after treatment ended, sustained viral response12). The mean (±standard deviation) proteinuria decreased from 2.61 ± 1.01 at baseline to 1.71 ± 1.43 (g/day) at sustained viral response 48, p = 0.031; microscopic hematuria and serum cryoglobulins disappeared in six (50%) and seven (64%) patients, respectively, after sustained viral response by direct-acting antivirals. Adverse events occurred in 69% (9/13) of patients and were mild, with four cases of ribavirin-related anemia requiring blood transfusions (no drop-outs). After sustained viral response by direct-acting antivirals, immunosuppressive and immunomodulatory agents were initiated in clinical relapsers ( n = 2) and nonresponders ( n = 3) with some benefit. Among patients on interferon-based regimens ( n = 12), viral response (sustained viral response 24) and dropout rates were 58% (7/12) and 33% (4/12), respectively. After sustained viral response by interferon-based therapy, clinical relapsers ( n = 3) were successfully managed with immunosuppressive agents in two patients. Conclusion: Treatment with direct-acting antivirals provides excellent rates of viral response and safety in patients with hepatitis C virus–related glomerular disease; viral response was frequently accompanied by clinical improvement. The absence of hepatitis C virus RNA from serum allowed immunosuppressive and immunomodulatory therapies with benefits for glomerular abnormalities and no concern on hepatitis C virus replication.

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