scholarly journals Rates of sustained virological response 12 weeks after the scheduled end of direct-acting antiviral (DAA)-based hepatitis C virus (HCV) therapy from the National German HCV registry: does HIV coinfection impair the response to DAA combination therapy?

HIV Medicine ◽  
2018 ◽  
Vol 19 (4) ◽  
pp. 299-307 ◽  
Author(s):  
J Bischoff ◽  
S Mauss ◽  
C Cordes ◽  
T Lutz ◽  
S Scholten ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Direct Acting Antiviral ◽  
Hcv Therapy ◽  
Hiv Coinfection ◽  
Direct Acting

scholarly journals Impact of Sustained Virological Response for Gastroesophageal Varices in Hepatitis-C-Virus-Related Liver Cirrhosis

2019 ◽  
Vol 9 (1) ◽  
pp. 95 ◽  
Author(s):  
Yukihisa Yuri ◽  
Hiroki Nishikawa ◽  
Hirayuki Enomoto ◽  
Kazunori Yoh ◽  
Yoshinori Iwata ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
P Value ◽  
Gastroesophageal Varices ◽  
Direct Acting Antiviral ◽  
Direct Acting

We aimed to clarify the relationship between sustained virological response (SVR) and gastroesophageal varices (GEVs) progression among hepatitis C virus (HCV)-related liver cirrhosis (LC) patients treated with interferon (IFN)-based therapies (n = 18) and direct-acting antiviral (DAA)-based therapies (n = 37), and LC patients with no SVR (n = 71) who had already developed GEVs. Factors influencing GEVs progression were also examined. During the follow-up period, GEVs progression was observed in 50 patients (39.7%). The 3-year cumulative GEVs progression rates in the DAA-SVR group, the IFN-SVR group, and the non-SVR group were 32.27%, 5.88%, and 33.76%, respectively (overall p value = 0.0108). Multivariate analysis revealed that sex (p = 0.0430), esophageal varices (EVs) F2 or more (p < 0.0001), and DAA-SVR (p = 0.0126, IFN-SVR as a reference) and non-SVR (p = 0.0012, IFN-SVR as a reference) were independent predictors for GEVs progression. The proportion of GEVs progression in patients with no or F1 EVs was significantly lower than that in patients with F2 or F3 EVs (33.9% (38/112) vs. 85.7% (12/14), p = 0.0003). In conclusion, IFN-based therapies can have a favorable impact for preventing GEVs progression in HCV-related LC patients with GEVs. Clinicians should be aware of a point of no return where SVR is no longer capable of avoiding GEVs progression.

scholarly journals Changes in the stage of fibrosis and steatosis in patients with chronic hepatitis C virus treated with direct-acting antiviral drugs who achieved sustained virological response

2020 ◽  
Vol 39 (3) ◽  
pp. 60-65
Author(s):  
Leona Radmanić ◽  
Adriana Vince ◽  
Snježana Židovec Lepej ◽  
Davorka Dušek ◽  
Ivan Kurelac ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Chronic Hepatitis C ◽  
Virological Response ◽  
Antiviral Drugs ◽  
Direct Acting Antiviral ◽  
Chronic Hepatitis C Virus ◽  
Direct Acting

Hepatitis C vodeći je uzrok kronične bolesti jetre, hepatocelularnog karcinoma i važna indikacija za transplantaciju jetre. Glavni cilj liječenja je postizanje trajnog virološkog odgovora koji označava negativnu viremiju 12 tjedana nakon završetka liječenja (SVR, od engl. sustained virological response). Uvođenjem antivirusnih lijekova s izravnim djelovanjem, povećala se stopa SVR-a, skratilo vrijeme trajanja terapije i utjecalo se na stadij fibroze i steatoze jetre nakon liječenja. Cilj ovog rada bio je analizirati promjenu stadija fibroze (F1-F4) i steatoze (S0-S3) primjenom tranzijentne elastografije u prethodno neliječenih bolesnika s kroničnim hepatitisom C (n=205) koji su postigli trajni virološki odgovor, a bili liječeni isključivo direktno djelujućim antivirusnim lijekovima (DAA).

Efficacy of Direct-Acting Antiviral Combination Therapy in the Treat-ment of Hepatitis C Virus Among Kidney Transplant Patients

2020 ◽  
Vol 18 ◽  
Author(s):  
Mohammed Al Atbee ◽  
Saad Shaheen Al-Taher ◽  
Majid Alabbood
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Kidney Transplant ◽  
Virological Response ◽  
Hepatitis C Virus Infection ◽  
Direct Acting Antiviral ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Direct Acting

Background: Up to date, there is no consensus on the best combination of direct-acting antiviral to treat hepatitis C virus in kidney transplant recipients. Objective: This study aims to analyze the efficacy of combination of sofosbuvir and ledipasvir regimen for treatment of hepatitis C virus infected kidney transplant patients. Method: A cross-sectional study conducted in a nephrology clinic and the Nephrology Center in Basrah Teaching Hospital from June 2015 to June 2018. Ledifos (90 mg Ledipasvir and 400 mg Sofosbuvir fixed-dose) was given as a single daily dose for all the participants for 12 weeks. Response for therapy was tested by follow up hepatitis C virus load at the end of 12 weeks and 24 weeks. The sustained virological response was defined as negative viral load of hepatitis C virus (aviremia) at the end of therapy. This study was done according to the Helsinki Congress. Results: A total of 60 (16 females) patients with renal transplantation and hepatitis C virus infection were included. Mean age was 40±6.2 years. A sustained virological response observed in all of the patients who received Ledifos after 12 and 24 weeks of therapy for all genotypes (1a, 1b and 4); p= 0.0001. Genotype 1a was more prevalent among males, 34 (56.6%); p= 0.0001, and it was the most common genotype tested negative serologically, 11 (18.3%). Conclusion: Ledifos therapy is effective and safe option for the treatment of hepatitis C virus infection in the post–renal transplant setting.

Liver Stiffness–Based Strategies Predict Absence of Variceal Bleeding in Cirrhotic Hepatitis C Virus–Infected Patients With and Without Human Immunodeficiency Virus Coinfection After Sustained Virological Response

2020 ◽  
Author(s):  
Anaïs Corma-Gómez ◽  
Juan Macías ◽  
Luis Morano ◽  
Antonio Rivero ◽  
Francisco Téllez ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Variceal Bleeding ◽  
Liver Stiffness ◽  
Low Risk ◽  
Hiv Coinfection ◽  
Immunodeficiency Virus

Abstract Background In the setting of hepatitis C virus (HCV) active infection, liver stiffness (LS)–based strategies identify patients with low risk of developing esophageal variceal bleeding (VB) episodes, in whom unnecessary upper esophagogastroduodenoscopy (UGE) screening can be safely avoided. However, after sustained virological response (SVR), data on the accuracy of the criteria predicting this outcome in HCV-infected patients with cirrhosis, with or without human immunodeficiency virus (HIV) coinfection, are very limited. Methods This was a multicenter prospective cohort study, where HCV-monoinfected patients and HIV/HCV-coinfected individuals were included if they had (1) SVR with direct-acting antiviral–based therapy; (2) LS ≥9.5 kPa previous to treatment; and (3) LS measurement at the SVR time-point ≥14 kPa. Diagnostic accuracy of HEPAVIR, expanded Baveno VI, and HIV cirrhosis criteria, at the time of SVR, was evaluated. Missed VB episodes, negative predictive values (NPVs), and number of spared UGEs were specifically assessed. Results Four hundred thirty-five patients were included, 284 (65%) coinfected with HIV. Seven (1.6%) patients developed a first episode of VB after SVR. In patients without a previous VB episode, HEPAVIR, expanded Baveno VI and HIV cirrhosis criteria achieved NPV for first VB episode after SVR of 99.5% (95% confidence interval [CI], 97.1%–100%), 100% (95% CI 97.8%–100%), and 100% (95% CI 98%–100%) while sparing 45%, 39%, and 44% of UGEs, respectively. When considering HIV coinfection, the performance of the 3 criteria was similar, both in HCV-monoinfected and HIV/HCV-coinfected individuals. Conclusions After SVR, predictive LS-based strategies accurately identify HCV-infected patients, HIV coinfected or not, with low risk of developing VB during follow-up. In these specific patients, using HIV cirrhosis criteria maximize the number of spared UGEs while missing no VB episode.

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