scholarly journals PATIENTS WITH HAEMOGLOBINOPATHIES AND CHRONIC HEPATITIS C: A REALLY DIFFICULT TO TREAT POPULATION IN 2016?

2016 ◽  
Vol 9 (1) ◽  
pp. e2017003 ◽  
Author(s):  
Kalliopi Zachou ◽  
Pinelopi Arvaniti ◽  
Nikolaos K. Gatselis ◽  
Kalliopi Azariadis ◽  
Georgia Papadamou ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Response To Treatment ◽  
Hcv Rna ◽  
Severe Liver Disease ◽  
Hcv Screening ◽  
The Stability ◽  
Direct Acting

Background & objectives: In the past, patients with haemoglobinopathies were at high risk for acquiring hepatitis C virus (HCV) due to multiple transfusions before HCV screening. In these patients the coexistence of haemochromatosis and chronic hepatitis C (CHC) often leads to more severe liver disease. We assessed the HCV prevalence, clinical characteristics and outcome in this setting with particular attention to the response to treatment including therapies with the new direct acting antivirals (DAAs).Methods: The medical records of 81 consecutive patients followed the last 15 years were reviewed retrospectively.Results: 43/81 (53%) patients were anti-HCV positive including 31/43 (72.1%) with CHC (HCV-RNA positive; age 25±7 years; 45.2% with genotype 1b; 19.4% cirrhotics; baseline ferritin 887 ng/ml; range: 81-10.820).  Thirty patients received IFN-based therapy with or without ribavirin with sustained virological response (SVR) in 14/30 (46.7%).   Eleven patients (9 non-responders to IFN-based therapies, 1 relapser and 1 naïve) received treatment with DAAs (SVR: 100%). 3/11 patients increased their transfusion needs while 1/11 reported mild arthralgias. No drug-drug interactions between DAAs and chelation agents were observed as attested by the stability of ferritin levels during treatment. Conclusions: More than 1/3 of patients with haemoglobinopathies suffered from CHC. Response rates to antiviral treatment seem to be similar to other patients with CHC, while treatment with DAAs was very effective and safe even in difficult to treat patients (most null responders with severe fibrosis) suggesting that this group of HCV patients should no longer be regarded as a difficult to treat.

scholarly journals Micro-elimination of Chronic Hepatitis C by Universal Screening plus Direct Acting Antivirals for Incarcerated Persons in Taiwan

2020 ◽  
Author(s):  
Tsung-Hua Yang ◽  
Yu-Jen Fang ◽  
Shih-Jer Hsu ◽  
Ji-Yuh Lee ◽  
Min-Chin Chiu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Universal Screening ◽  
Virologic Response ◽  
Hcv Rna ◽  
Direct Acting Antiviral ◽  
Hcv Antibody ◽  
Hcv Screening ◽  
Direct Acting

Abstract Background Incarcerated persons are a special population with higher hepatitis C virus (HCV) prevalence and should be prioritized for micro-elimination. This study aimed to investigate the seroprevalence and to evaluate the effectiveness and safety of direct acting antiviral (DAA) therapy in the custodial settings. Methods Incarcerated persons in Yunlin Prison were recruited to receive anti-HCV antibody screening. Patients with positive HCV ribonucleic acid (HCV RNA) were treated with glecaprevir/pibrentasvir (GLE/PIB) in our special chronic hepatitis C (CHC) clinic in prison. The primary endpoint was sustained virologic response at week 12 off therapy (SVR12). Results A total of 1402 incarcerated persons were invited to anti-HCV screening and 824 (58.7%) accepted. The prevalence of anti-HCV positivity was 33.5% (276/824) and the viremic rate (detectable HCV RNA) was 69.2% (191/276). According to FIB-4 index, patients with F3 stage were six (3.1%), but none met the criteria of F4 stage. However, six (3.1%) had liver cirrhosis with splenomegaly, confirmed by findings of ultrasonography. The median log10 HCV RNA level at baseline was 6.235 (2.394-7.403). Genotype (GT) 6 was predominant (39.3%), followed by GT 1a (22.0%) and 1b (14.1%). Mixed genotype HCV infection accounted for 3.6% of total infections. In total, 165 patients received GLE/PIB therapy. The overall SVR12 rates were 100%. Conclusions DAA therapy is highly effective and safe for incarcerated patients in Taiwan. Our special prison-based CHC clinic, linking universal screening to medical care, can serve as a model for micro-elimination of HCV in custodial settings.

Changes in Serum Level of Autotaxin with Direct-Acting Antiviral Therapy in Patients with Chronic Hepatitis C

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Mohamed Hussein Abdelwahab ◽  
Shereen Abou Bakr Saleh ◽  
Ghada Abdelrahman Ahmed ◽  
Asmaa Mady Gomaa Mady
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Serum Level ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Post Treatment ◽  
Direct Acting Antiviral ◽  
Direct Acting

Abstract Background Hepatitis C virus virus is global health burden and major health hazard in Egypt, since the virus is the etiological factor of chronic hepatitis. Hepatitis C virus (HCV) accounts for approximately 15%-20% cases of acute hepatitis. After acute infection, around 50% to 80% of HCV patients will develop chronic infection. Approximately, HCV infects 170 million individuals worldwide). Chronic hepatitis C (CHC) patients are at high risk to develop lifethreatening complications, including cirrhosis in 20% of cases and hepatocellular carcinoma. Objectives The aim of this study was to validate Changes in serum level of autotaxin in patients with chronic hepatitis C before and after antiviral treatment. Patients and methods This study was designed as a prospective observational cohort study to evaluate Changes in serum levels of autotaxin with direct-acting antiviral therapy in patients with chronic hepatitis C before (baseline) and after (sustained virologic response week 12) treatment. This prospective study was conducted on 48 chronic HCV infected patients eligible for antiviral treatment with direct acting antivirals, agreeable to regular follow up, recruited from Hepatology and virology outpatient clinic at DMNI (Damanhour Medical National Institute) during the period from September 2018 till Mars 2019. Results This study showed that Autotaxin level significantly decreased from baseline to 12 weeks post-treatment. ATX therefore represents a novel non-invasive biomarker for liver fibrosis and a prognostic indicator of disease activity. Conclusion Serum Autotaxin was found to be higher in chronic hepatitis c and ATX levels became significantly decreased from baseline to 12 weeks post-treatment with direct acting antiviral drugs in patients achieving a SVR.

scholarly journals Efficacy of direct-acting antiviral treatment for chronic hepatitis C: A single hospital experience

2018 ◽  
Vol 10 (1) ◽  
pp. 88-94
Author(s):  
Rena Kaneko ◽  
Natsuko Nakazaki ◽  
Risa Omori ◽  
Yuichiro Yano ◽  
Masazumi Ogawa ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Direct Acting Antiviral ◽  
Hospital Experience ◽  
Direct Acting

The health impact of delaying direct‐acting antiviral treatment for chronic hepatitis C: A decision‐analytic approach

2019 ◽  
Vol 40 (1) ◽  
pp. 51-59
Author(s):  
Aysegul Erman ◽  
William W. L. Wong ◽  
Jordan J. Feld ◽  
Paul Grootendorst ◽  
Murray D. Krahn
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Health Impact ◽  
Analytic Approach ◽  
Direct Acting Antiviral ◽  
Direct Acting

Direct-acting antivirals and interferon-based therapy on hepatocellular carcinoma risk in chronic hepatitis-C patients

2020 ◽  
Vol 16 (11) ◽  
pp. 675-686
Author(s):  
Longteng Ma ◽  
Jiluo Liu ◽  
Wei Wang ◽  
Fan Yang ◽  
Ping Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Meta Analysis ◽  
Antiviral Treatment ◽  
Direct Acting Antiviral ◽  
Study Results ◽  
Direct Acting ◽  
Better Than

Aim: It was controversial whether direct-acting antiviral (DAA) is better than interferon-based therapy (IBT) in preventing HCV-related hepatocellular carcinoma (HCC). Therefore, we accomplished this large, stepwise meta-analysis. Materials & methods: The PubMed, Cochrane and ScienceDirect were searched for studies published during January 2009–March 2019. Antiviral type, number of chronic hepatitis C (CHC) patients, number of HCC cases from CHC patients, sustained virological response (SVR) status and important covariate data were extracted from each study. Results & conclusion: It is demonstrated that antiviral treatment reduces the occurrence of HCC in patients with CHC; achieving SVR to antiviral treatment reduces HCC; DAA treatment is not better than IBT in the prophylaxis of HCC; DAA treatment and cirrhosis are independently associated with a higher incidence of HCC than IBT in middle-aged CHC patients who achieve SVR.

Increased peripheral CD4 + regulatory T cells persist after successful direct-acting antiviral treatment of chronic hepatitis C

2017 ◽  
Vol 66 (5) ◽  
pp. 888-896 ◽  
Author(s):  
Bettina Langhans ◽  
Hans Dieter Nischalke ◽  
Benjamin Krämer ◽  
Annekristin Hausen ◽  
Leona Dold ◽  
...  
Keyword(s):  
T Cells ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Regulatory T Cells ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Direct Acting Antiviral ◽  
Direct Acting
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