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Ahn YH, Lee H, Han JE, Cho HJ, Cheong JY, Park B, Kim SS. Effect of direct-acting antivirals for hepatitis C virus-related hepatocellular carcinoma recurrence and death after curative treatment. J Liver Cancer 2022; 22:125-135. [PMID: 37383412 PMCID: PMC10035739 DOI: 10.17998/jlc.2022.05.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/13/2022] [Accepted: 05/24/2022] [Indexed: 06/30/2023]
Abstract
Background/Aim There has been a long-standing debate about the association of directacting antiviral (DAA) therapy and hepatocellular carcinoma (HCC) recurrence. This study aimed to investigate the association between DAA therapy and HCC recurrence after curative therapy. Methods We retrospectively enrolled 1,021 patients with HCV-related (hepatitis C virus) HCC who underwent radiofrequency ablation (RFA), liver resection, or both as the first treatment modality from January 2007 to December 2016 and without a history of HCV therapy before HCC treatment from a nationwide database. The effect of HCV treatment on HCC recurrence and all-cause mortality was also investigated. Results Among the 1,021 patients, 77 (7.5%) were treated with DAA, 14 (1.4%) were treated with interferon-based therapy, and 930 (91.1%) did not receive HCV therapy. DAA therapy was an independent prognostic factor for lower HCC recurrence rate (hazard ratio [HR], 0.04; 95% confidence interval [CI], 0.006-0.289; P=0.001 for landmarks at 6 months after HCC treatment and HR, 0.05; 95% CI, 0.007-0.354; P=0.003 for landmarks at 1 year). Furthermore, DAA therapy was associated with lower all-cause mortality (HR, 0.049; 95% CI, 0.007-0.349; P=0.003 for landmarks at 6 months and HR, 0.063; 95% CI, 0.009-0.451; P=0.006 for landmarks at 1 year). Conclusions DAA therapy after curative HCC treatment can decrease HCC recurrence and all-cause mortality compared to interferon-based therapy or no antiviral therapy. Therefore, clinicians should consider administering DAA therapy after curative HCC treatment in patients with HCV-related HCC.
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Affiliation(s)
- Young-Hwan Ahn
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Heirim Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea
| | - Ji Eun Han
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Hyo Jung Cho
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Jae Youn Cheong
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Korea
| | - Soon Sun Kim
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
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Han SY, Woo HY, Heo J, Park SG, Pyeon SI, Park YJ, Kim DU, Kim GH, Kim HH, Song GA, Cho M. The predictors of sustained virological response with sofosbuvir and ribavirin in patients with chronic hepatitis C genotype 2. Korean J Intern Med 2021; 36:544-556. [PMID: 30879288 PMCID: PMC8137398 DOI: 10.3904/kjim.2018.329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/15/2018] [Accepted: 01/23/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIMS Real-world, clinical practice data are lacking about sofosbuvir/ ribavirin (SOF/RBV) treatment of Korean patients with hepatitis C virus genotype 2 (HCV GT2) infection. This study investigated the efficacy and safety of SOF/RBV in Korean patients with HCV GT2 infection and clinical factors predicting sustained virological response 12 weeks (SVR12) after the end of SOF/RBV treatment. METHODS A total of 181 patients with HCV GT2 with/without cirrhosis were treated with SOF/RBV for 16/12 weeks. Rapid virological response (RVR) was defined as non-detectable HCV RNA at 4 weeks. RESULTS The RVR rate was 80.7% (146/181), the end of treatment response rate was 97.8% (177/181) and the SVR12 rate was 92.8% (168/181). Of eight patients with relapse, four did not achieve RVR. Three patients had a history of hepatocellular carcinoma (HCC). Multivariable analysis showed that RVR (p = 0.015) and no previous history of HCC (p = 0.007) were associated with SVR12. Factors significantly contributing to RVR included cirrhosis, creatinine concentration, and pre-treatment HCV RNA level. SVR12 rate was significantly higher in RVR (+) than RVR (-) patients (95.2% vs. 82.9%, p = 0.011) and also significantly higher in patients without than with a history of HCC (94.1% vs. 72.7%, p = 0.008). During treatment, 80/181 patients (44.2%) experienced mild to moderate adverse events, with 32 (17.7%) requiring RBV dose reductions due to anemia. CONCLUSION SOF/RBV treatment was effective and tolerable in HCV GT2 patients. RVR and no previous history of HCC were positive predictors of SVR12.
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Affiliation(s)
- Sung Yong Han
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun Young Woo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jeong Heo
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sang Gyu Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung Ik Pyeon
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Young Joo Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Dong Uk Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyung Hoi Kim
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
- Department of Laboratory Medicine, Pusan National University School of Medicine Busan, Korea
| | - Geun Am Song
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Mong Cho
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute, Pusan National University Hospital, Busan, Korea
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Pereira Guedes T, Garrido M, Kuttner Magalhães R, Moreira T, Rocha M, Maia L, Manuel Ferreira J, Morais S, Pedroto I. Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection. GE Port J Gastroenterol 2021; 28:79-86. [PMID: 33791394 PMCID: PMC7991614 DOI: 10.1159/000510023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/24/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Persons with haemophilia (PWH) used to represent a population with a high prevalence of hepatitis C virus (HCV) infection due to the use of contaminated blood products. Although the goals of antiviral therapy are the same as the general population, long real-life follow-up data regarding their outcomes are still scarce. Our aim was to report the outcomes of HCV infection and the results of antiviral therapy in PWH. METHODS A retrospective analysis was performed in a single-centre cohort of PWH with positive HCV antibody. Outcomes registered were rate of spontaneous clearance of HCV, sustained virologic response (SVR) achievement, development of end-stage liver disease, and all-cause and liver-related mortality. RESULTS Out of 131 PWH, 73 (55.7%) had positive HCV antibody. During a median follow-up time of 22 years, 46 patients (63.9%) developed chronic hepatitis C, of which 16 (34.8%) developed cirrhosis. Treatment was pursued in 34 PWH. Most (n = 32) were first treated with interferon (IFN)-based regimens with SVR rates of 40.6%. Direct-acting antivirals were used in 14 IFN-experienced and 2 naïve patients, with an overall SVR rate of 100%. Overall, 17 patients (23.3%) died during the follow-up, only 4 related to liver disease. Of these, none had achieved SVR. CONCLUSIONS We describe the outcomes of a cohort of Portuguese PWH and hepatitis C exposure after two decades of follow-up, with a lower mortality than previously described. Our response rates to HCV treatment were comparable to those in the general population and stress the importance of early treatment.
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Affiliation(s)
- Tiago Pereira Guedes
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mónica Garrido
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | - Teresa Moreira
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Marta Rocha
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Maia
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - José Manuel Ferreira
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Sara Morais
- Haematology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Isabel Pedroto
- Gastroenterology Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
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Cao X, Zhang Y, Nan YM, Tan ZN, Chen CY, Shang QH, Liu XE, Zhuang H. [Application of serum N -glycan profiling diagnostic model in evaluation of liver fibrosis in patients with hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:1023-1029. [PMID: 34865350 DOI: 10.3760/cma.j.cn501113-20190928-00359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To study the changes of serum N-glycan abundance in patients with liver fibrosis at different stages of hepatitis C, and to establish and evaluate the diagnostic model for clinical application value. Methods: Data of 169 hepatitis C virus-infected cases with liver fibrosis were enrolled. Nine kinds of serum N-glycans were detected and analyzed using DNA sequencer-assisted fluorophore-assisted capillary electrophoresis technology. A binary logistics regression method was used to establish a diagnostic model based on the changes in the relative content of N-glycans in each stage of liver fibrosis. Receiver operating characteristic curve was used to evaluate and compare the diagnostic efficacy with other liver fibrosis diagnostic models. Results: N-glycan diagnostic model (B and C) had highest AUROC= 0.776, 0.827 for distinguishing fibrosis S1~S2 to S3~S4 and S1~S3 to S4 than GlycoFibroTest (AUROC = 0.760, 0.807), GlycoCirrhoTest (AUROC = 0.722, 0.787), aspartate aminotransferase to platelet ratio index (AUROC = 0.755, 0.751), FIB-4 index (AUROC = 0.730, 0.774), and S-index (AUROC = 0.707, 0.744). However, the diagnostic efficacy of model A (AUROC = 0.752) for distinguishing fibrosis S1 with S2~S4 had lower diagnostic potency than that of the aspartate aminotransferase to platelet ratio index (AUROC = 0.807). Diagnostic efficiency was improved when the N-glycan profiling and the aspartate aminotransferase to platelet ratio index were combined to diagnose liver fibrosis in each stage, and the area under the receiver operating characteristic curve was 0.839, 0.825, and 0.837, respectively. Conclusion: The serum N-glycan profiling diagnostic model has potential clinical application value in the diagnosis of liver fibrosis in patients with hepatitis C.
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Affiliation(s)
- X Cao
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Y Zhang
- Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China
| | - Y M Nan
- Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China
| | - Z N Tan
- Department of Molecular Biomedical Research, Xian si-da Biotechnology Company Limited, Nanjing 210000, China
| | - C Y Chen
- Department of Molecular Biomedical Research, Xian si-da Biotechnology Company Limited, Nanjing 210000, China
| | - Q H Shang
- Department of Liver Disease, No. 88 Hospital of Chinese People's Liberation Army, Tai'an 271000, China
| | - X E Liu
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - H Zhuang
- Department of Microbiology and Center of Infectious Diseases, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
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Li JP, Chen XF, Yan Q, Zhang YJ, Xie ZW, Xia Y, Guan YJ. [Effectiveness and safety of sofosbuvir/velpatasvir combination ± ribavirin in the treatment of Chinese adults with chronic hepatitis C virus infection]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:831-837. [PMID: 33105927 DOI: 10.3760/cma.j.cn501113-20200831-00486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand the effectiveness and safety sofosbuvir/velpatasvir (SOF/VEL) combination ±ribavirin in the treatment of chronic hepatitis C virus (HCV) infection in China. Methods: A total of 96 Chinese adults with chronic HCV infection who were treated with SOF/VEL combination ± ribavirin for 12 weeks between July 2018 and February 2020 were selected. HCV RNA, routine blood test, liver, kidney and coagulation function, abdominal Color Doppler ultrasound or CT and liver stiffness were detected at baseline, 4 weeks of treatment, end of treatment and 12 weeks of follow-up. Adverse events and laboratory abnormalities during the treatment were recorded. A t-test was used to compare the measurement data between the two groups, and the analysis of variance was used for multiple group comparison. Results: A total of 93 cases (96.9%) achieved sustained virological response (SVR12), of which 3 cases had relapsed. 88 cases (91.7%, 88/96) had achieved rapid virological response (RVR). 96 cases (100%) had achieved virological response by the end of treatment (EOT). In patients with decompensated liver cirrhosis, the average baseline Child-Pugh score and Model for End-Stage Liver Disease score was 7.4±1.0, and 11.4±1.7, respectively. Among them, 12 cases of the SOF/VEL combined with RBV treatment had achieved SVR12 (100%) at 12 weeks, while only 3 of the 5 cases of single-tablet regimen of SOF/VEL had achieved SVR12 (60%). There was no significant difference between creatinine levels and baseline during or 12 weeks after treatment. The incidence of adverse events in patients with chronic hepatitis C and compensated cirrhosis was 6.3% (5/79), while that in patients with decompensated cirrhosis was 35.3% (6/17). The most common adverse events were hyperbilirubinemia, fatigue and anemia. There were no serious adverse events, deaths or discontinuation of treatment due to adverse events. Conclusion: SOF/VEL combination ± ribavirin in the treatment of various common genotypes of chronic hepatitis C, compensated cirrhosis, decompensated cirrhosis and hepatocellular carcinoma has higher SVR12 in China, and the tolerance and safety are good.
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Affiliation(s)
- J P Li
- Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China
| | - X F Chen
- Infectious Department of Guangdong General Hospital, Guangzhou 510080, China
| | - Q Yan
- Department of Liver Diseases, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052 , China
| | - Y J Zhang
- Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China
| | - Z W Xie
- Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China
| | - Y Xia
- Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China
| | - Y J Guan
- Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China
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Wang XZ, Wei L. [Current status, treatment and prospect of patients with chronic hepatitis C genotype 3 in China]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:824-826. [PMID: 33105925 DOI: 10.3760/cma.j.cn501113-20200925-00532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic hepatitis C (CHC) is one of the most important causes of chronic liver disease in the world. Among them, chronic hepatitis C with genotype 3 is closely related to the progression of liver disease, and its treatment is still challenging. With the passage of time, the proportion of patients with chronic hepatitis C genotype 3 has been on the rise in China, which raises the difficulty of treatment. Therefore, we need to combine domestic and foreign research to explore a more suitable plan for Chinese patients with chronic hepatitis C genotype 3.
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Affiliation(s)
- X Z Wang
- Department of Liver Diease, Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, Urumqi 830000, China
| | - L Wei
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital School of Clinical Medicine Tsinghua University, Beijing 102218, China; China Liver Health, Beijing 100070, China
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7
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Li Y, Li LX, Zhang XJ, Yuan LJ, Xi FY, Zhang H, Zhang LX. [Interaction of notch signaling pathway with toll-like receptor 4 on the function of CD14+ monocytes in chronic hepatitis C patients]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:527-532. [PMID: 31357779 DOI: 10.3760/cma.j.issn.1007-3418.2019.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To observe the expressional changes in Notch signaling pathway and toll-like receptor 4 (TLR4) and their interactions on the functions of CD14(+) monocytes in chronic hepatitis C patients. Methods: A total of 24 treatment-naïve chronic hepatitis C cases and 10 healthy individuals, who visited Shaanxi Provincial People's Hospital from August to October 2017, were enrolled. Selected CD14(+) monocytes were stimulated by the Notch signaling pathway inhibitor DAPT or transfected with TLR4 siRNA, and the levels of Notch1, Notch2, Hes1 and Hes5 mRNA were detected by real-time quantitative PCR. TLR4 protein levels and phosphorylation of NF-κB was detected by Western blot. ELISA was used to detect the level of cytokines secreted from CD14(+) monocytes. A t-test or paired t-test was used for comparison between groups. Results: The relative expression of Notch1 mRNA (3.97 ± 2.03 vs. 0.91 ± 0.76, P < 0.01) and downstream of Notch signaling pathway (5.96 ± 2.31 vs. 0.99 ± 0.45, P < 0.01), Hes1 mRNA and Hes5 mRNA (4.31 ± 1.05 vs. 0.84 ± 0.20, P < 0.01) in CD14+ monocytes of chronic hepatitis C patients was significantly higher than that of healthy individuals. The relative expression of TLR4 mRNA (5.14 ± 1.09 vs. 1.27 ± 0.39) and protein level in CD14(+) monocytes of chronic hepatitis C patients were significantly higher than those of healthy individuals (P < 0.01). An inhibition of Notch signaling pathway with DAPT had reduced the relative expression level of TLR4 mRNA (2.58 ± 1.36 vs. 4.34 ± 1.88, P < 0.05), protein expression and phosphorylation of NF-B in CD14(+) monocytes of chronic hepatitis C patients. Furthermore, the secretion level of MCP-1 [(94.32 ± 23.59) pg/ml vs. (64.07 ± 9.39) pg/ml, P < 0.01] and IL-8 [(12.54 ± 4.89) pg/ml vs. (7.92 ± 3.01) pg/ml, P < 0.05] was significantly reduced. TLR4 siRNA transfection reduced the expressions of Notch1 mRNA (2.09 ± 1.72 vs. 3.73 ± 1.75, P < 0.05), Hes1 (2.87 ± 0.84 vs. 5.54 ± 0.97, P < 0.01), and Hes5 (2.89 ± 0.93 vs. 4.51 ± 1.54, P < 0.01) in CD14(+) monocytes of chronic hepatitis C patients. Conclusion: Interaction of Notch signaling pathway with TLR4 can promote the function of CD14(+) monocytes in chronic hepatitis C patients.
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Affiliation(s)
- Y Li
- Department of Infectious Diseases, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - L X Li
- Department of Gynecology, Shaanxi Provincial Hospital People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - X J Zhang
- Department of Scientific Research, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - L J Yuan
- Department of Infectious Diseases, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - F Y Xi
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - H Zhang
- Department of Infectious Diseases, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
| | - L X Zhang
- Department of Clinical Laboratory, Shaanxi Provincial People's Hospital and The Affiliated Hospital of Xi'an Medical University, Xi'an 710068, China
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Jun BG, Park EJ, Lee WC, Jang JY, Jeong SW, Kim YD, Cheon GJ, Cho YS, Lee SH, Kim HS, Lee YN, Kim SG, Kim YS, Kim BS. Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C. Korean J Intern Med 2019; 34. [PMID: 29529840 PMCID: PMC6718746 DOI: 10.3904/kjim.2017.322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND/AIMS This study was conducted to clarify the sustained virological response (SVR) prediction ability of baseline and treatment-related factors in patients with chronic hepatitis C virus (HCV) infection. METHODS This retrospective study collected data at four tertiary referral hospitals between June 2004 and July 2012. Out of 476 patients, 330 treatment-naïve patients with chronic HCV infection were recruited. Pegylated interferon α-2a/- 2b plus ribavirin was administered for either 24 or 48 weeks depending on the HCV genotype. The baseline and treatment-related predictive factors of SVR were evaluated by analyzing data measured before treatment (i.e., baseline) and during treatment. RESULTS SVR rates for genotypes 1 and 2 were 63% (97/154) and 79.5% (140/176), respectively (p = 0.001). Multivariate analysis for baseline factors revealed that young age (p = 0.009), genotype 2 (p = 0.001), HCV RNA level of < 800,000 IU/mL (p < 0.001), and a baseline platelet count of > 150 × 103 /µL (p < 0.001) were significant SVR predictors, regardless of the genotype. In particular, predictive accuracy for achievement of SVR was 87.3% for a baseline platelet count of > 150 × 103 /µL. In multivariate analysis for treatment-related factors, SVR was associated with achievement of a rapid virological response (RVR; p < 0.001), treatment adherence of ≥ 80/80/80 (p < 0.001). CONCLUSION Young age, genotype 2, low HCV RNA level, RVR, and treatment adherence were significantly associated with SVR. In addition, platelet count was an independent predictive factor for SVR. Therefore, platelet count could be used to develop individualized treatment regimens and to optimize treatment outcomes in patients with chronic HCV infection.
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Affiliation(s)
- Baek Gyu Jun
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Eui Ju Park
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Woong Cheul Lee
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jae Young Jang
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Correspondence to Jae Young Jang, M.D. Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan- gu, Seoul 04401, Korea Tel: +82-2-709-9202 Fax: +82-2-709-9696 E-mail:
| | - Soung Won Jeong
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Young Don Kim
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Gab Jin Cheon
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Young Sin Cho
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Sae Hwan Lee
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hong Soo Kim
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Yun Nah Lee
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sang Gyune Kim
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Young Seok Kim
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Boo Sung Kim
- Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Oh JY, Kim BS, Lee CH, Song JE, Lee HJ, Park JG, Hwang JS, Chung WJ, Jang BK, Kweon YO, Tak WY, Park SY, Jang SY, Suh JI, Kwak SG. Daclatasvir and asunaprevir combination therapy for patients with chronic hepatitis C virus genotype 1b infection in real world. Korean J Intern Med 2019; 34:794-801. [PMID: 29792020 PMCID: PMC6610199 DOI: 10.3904/kjim.2017.368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/29/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/AIMS Previous studies have reported a high rate of sustained virologic response (SVR) and a low rate of serious adverse events with the use of daclatasvir (DCV) and asunaprevir (ASV) combination therapy. We evaluated the efficacy and safety of DCV and ASV combination therapy for patients with chronic hepatitis C virus (HCV) genotype 1b infection in real world. METHODS We enrolled 278 patients (184 treatment-naïve patients) from five hospitals in Daegu and Gyeongsangbuk-do. We evaluated the rates of rapid virologic response (RVR), end-of-treatment response (ETR), and SVR at 12 weeks after completion of treatment (SVR12). Furthermore, we investigated the rate of adverse events and predictive factors of SVR12 failure. RESULTS The mean age of patients was 59.5 ± 10.6 years, and 140 patients (50.2%) were men. Seventy-seven patients had cirrhosis. Baseline information regarding nonstructural protein 5A (NS5A) sequences was available in 268 patients. Six patients presented with pretreatment NS5A resistance-associated variants. The RVR and the ETR rates were 96.6% (258/267) and 95.2% (223/232), respectively. The overall SVR12 rate was 91.6% (197/215). Adverse events occurred in 17 patients (7.9%). Six patients discontinued treatment because of liver enzyme elevation (n = 4) and severe nausea (n = 2). Among these, four achieved SVR12. Other adverse events observed were fatigue, headache, diarrhea, dizziness, loss of appetite, skin rash, and dyspnea. Univariate analysis did not show significant predictive factors of SVR12 failure. CONCLUSION DCV and ASV combination therapy showed high rates of RVR, ETR, and SVR12 in chronic HCV genotype 1b-infected patients in real world and was well tolerated without serious adverse events.
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Affiliation(s)
- Jae Young Oh
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Byung Seok Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
- Correspondence to Byung Seok Kim, M.D. Department of Internal Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-gu, Daegu 42472, Korea Tel: +82-53-650-4090 Fax: +82-53-656-3281 E-mail:
| | - Chang Hyeong Lee
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jeong Eun Song
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Heon Ju Lee
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jung Gil Park
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Jae Seok Hwang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Woo Jin Chung
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Byoung Kuk Jang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Young Oh Kweon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Won Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Soo Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Se Young Jang
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong Ill Suh
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| | - Sang Gyu Kwak
- Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, Korea
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Park SJ, Kim AR, Choe WH, Kim JH, Yoo BC, Kwon SY. The Efficacy and Safety of Direct-acting Antiviral Treatment for Chronic Hepatitis C Patients: A Single Center Study. Korean J Gastroenterol 2019; 72:197-204. [PMID: 30419644 DOI: 10.4166/kjg.2018.72.4.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background/Aims Direct-acting antiviral (DAA) therapy has been shown to achieve a high rate of sustained virologic response (SVR) and favorable outcomes in chronic hepatitis C (CHC) patients. We investigated the virologic response and its clinical impact in CHC patients. Methods CHC patients with compensated liver function treated with DAAs between 2016 and 2017 were included for retrospective analysis. We analyzed baseline characteristics and virologic and biochemical responses at on-treatment 4 weeks, end of treatment, and post-treatment 12 weeks. Fibrosis was measured as liver stiffness measurement by transient elastography (FibroScan). Adverse events were monitored during the treatment period. Results A total of 135 patients (61.5% with genotype [GT] 1b and 38.5% with GT 2a) were enrolled 47.4% were male, 79.3% were treatment naive, and 30.4% had cirrhosis. SVR 12 was observed in 97.6% (81/83) in the GT 1b and 98.1% (51/52) in the GT 2a; treatment with daclatasvir+asunaprevir was the most commonly used in GT 1b (55/83), and sofosbuvir+ribavirin was the most commonly used in GT 2a (49/52). The median change of liver stiffness measurement at two time points using the signed rank test was -3.2 kPa in patients who underwent transient elastography before treatment and at SVR 12 (n=25). The most common adverse events were anemia, dyspepsia, and insomnia. One GT 2a patient treated with sofosbuvir+ribavirin stopped the treatment at 8 weeks due to symptomatic bradyarrhythmia; however, he recovered spontaneously and achieved SVR 12. Conclusions DAA treatment of chronic hepatitis C genotype 1b and 2a resulted in a high rate of sustained virologic response and improvement of liver fibrosis score.
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Affiliation(s)
- Seong Jun Park
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Ah Ran Kim
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Won Hyeok Choe
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Jeong Han Kim
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - Byung Chul Yoo
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
| | - So Young Kwon
- Division of Gastroenterology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea
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11
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Jie YS, Yuan J, Zhang XH, Guan YJ, Zhao ZX, Chong YT, Tao L, Li JP, Lin CS. [Real-world study of paritaprevir/ritonavir-ombitasvir combined with dasabuvir for the treatment of chronic hepatitis C 1b genotype infection in China]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:123-7. [PMID: 30818917 DOI: 10.3760/cma.j.issn.1007-3418.2019.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the real-world safety and curative effect of ombitasvir combined with dasabuvir for the treatment of chronic hepatitis C 1b genotype infection in non-cirrhotic or compensated cirrhotic patients. Methods: A real-world research method was adopted, and the research was conducted at three medical centers of mainland China. Non- cirrhotic or compensated cirrhotic patients with HCV genotype 1b infection who were initially treated with IFN/PEG-IFN-alpha combined with ribavirin, and ombitasvir combined with dasabuvir for 8 or 12 weeks were taken. Sustained virological response (SVR) and the incidence of adverse events during treatment and follow-up were evaluated after 12 weeks of drug withdrawal at OBV/PTV/r 25/150/100mg once daily and DSV 250mg, twice daily. Median and range were used for description of non-normally distributed data. Results: 80 cases of GT1b were included in this study. Of these 88.8% (71/80) were newly diagnosed, 12.5% (10/80) were compensated cirrhotic, 97.5% (78/80) received 12 weeks treatment, and 2.5% (2/80) received 8 weeks treatment. The rate of HCV RNA negative at EOT (end of treatment) was 100% (64/64). A total of 67 patients completed the treatment within 12 weeks, and 43 patients returned to the hospital for further consultations, and SVR12 was 100%(43/43). No patient discontinued the drugs because of an adverse event during treatment. Conclusion: In the real world, Ombitasvir combined with dasabuvir for the treatment of chronic hepatitis C 1b genotype infection in China has 100% rates of EOT and SVR12 with well- tolerability and safety.
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Wei JY, Lin DN, Wu ZB, Zhu JY, Zhao ZX, Mei YY, Lin CS, Zhang J, Zhang XH. [Safety and efficacy of DCV-based DAAs therapy for chronic HCV infection in China]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:933-939. [PMID: 30669787 DOI: 10.3760/cma.j.issn.1007-3418.2018.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the efficacy and safety of DCV-based DAAs therapy for chronic HCV infected Chinese patients. Methods: An open-label, non-randomized, prospective study was designed. Fifty-two patients with chronic HCV infection were enrolled. Among them, there was one patient after liver transplantation, 2 patients after kidney transplantation, 3 patients with hepatocellular carcinoma, and 4 patients with HBV infection. Thirteen cases with chronic hepatitis C (one compensated cirrhosis) who were negative for resistance-related variants [NS5A RAS (-)] of gene 1b and NS5A were treated with daclatasvir (DCV) + asunaprevir (ASV) for 24 weeks. Twenty-five cases of CHC (six compensated cirrhosis) with GT 1b, 2a, 3a, 3b, 6a were treated with DCV + SOF ± RBV for 24 weeks. 8 cases with decompensated cirrhosis of gene 1b and NS5A RAS(-) were given DCV + SOF + RBV regimen for 12 weeks. Six cases with decompensated cirrhosis, of gene 2a, 1b, 2a, 3a, 3b, were given DCV + SOF + RBV regimen for 24 weeks. HCV RNA, blood routine test, liver and kidney function, and upper abdominal ultrasound/MRI were measured at baseline, 4 weeks of treatment, end of treatment, and 12 weeks of follow-up. The incidence of adverse events and laboratory abnormalities during treatment were recorded. A t-test was used to compare the measurement data between two groups, and analysis of variance was used to compare the measurement data between multiple groups. Results: Sixteen patients (100%) achieved SVR12 after treatment, with 0% recurrence rate. Rapid virological response (RVR) of the four treatment regimens were 76.92%, 54.17%, 87.50%, and 83.33%, respectively, and 32 patients achieved 100% virological response after the completion of treatment. The incidence of adverse events of chronic hepatitis C with cirrhosis and decompensated cirrhosis was 62.5% and 64.29%, respectively. The most common adverse event was fatigue in CHC (25.00%), and elevated indirect bilirubin in decompensated cirrhosis (42.86%). No serious adverse drug events, deaths or adverse reactions occurred. Conclusion: DCV-based DAAs regimen is promising option for the treatment of HCV genotypes, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and HCV infection after liver/kidney transplantation in china. Above all, it has high SVR12 with good tolerability and safety profile.
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Affiliation(s)
- J Y Wei
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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13
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Song GJ, Rao HY, Gao YH, Feng B, Wei L. [Incidence of depressive disorders and related independent risk factors in patients with chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:33-38. [PMID: 30685921 DOI: 10.3760/cma.j.issn.1007-3418.2019.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the incidence and related independent risk factors of depression in treatment-naïve Han ethnic Chinese patients with chronic hepatitis C. Methods: Nine hundred and ninety-seven Han Chinese patients with confirmed chronic HCV infection were enrolled. Beck's depression inventory scale was used to assess depression score. Patients were divided into two groups according to the score: score≥17, depression group (16.85%, 168/997); score <17, no depression group (83.15%, 829/997). Multivariate logistic regression was used to analyze independent risk factors related with the onset of depression in patients with chronic hepatitis C. Results: There was a statistically significant difference between the two groups in terms of gender distribution, marital status, education level, income level and smoking status (P < 0.05). Independent risk factors were female [odds ratio (OR) = 3.85; 95% CI: 2.28-6.50, P = 0.001], decompensated cirrhosis [OR = 2.31; 95% CI: 1.20-4.48, P = 0.013], unmarried [OR = 2.01; 95% CI: 1.12-3.60, P = 0.019], separated [OR = 17.39; 95% CI: 1.64-184.47, P = 0.018], divorced [OR = 3.82; 95% CI: 1.36-10.74, P = 0.011], without higher education [OR = 2.04; 95% CI: 1.22-3.42, P = 0.007], low income [OR = 3.94; 95% CI: 1.38-11.28, P = 0.011], middle income [OR = 2.96; 95% CI: 1.02-8.62, P = 0.047], uninterrupted smoking [OR = 3.67; 95% CI: 2.13-6.31, P = 0.001], and previously smoked [OR = 3.33, 95% CI: 1.66-6.68, P = 0.001]. Conclusion: The incidence of depression in patients with chronic hepatitis C is relatively high. The independent risk factors related with depression include female, unmarried, separated, and divorced, without higher education, low and middle-income level, smoking and disease progression to decompensated cirrhosis, but no significant correlation between hepatitis C virus genotypes and viral load.
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Affiliation(s)
- G J Song
- Hepatology Department, Peking University People's Hospital, Peking University Hepatology Institute, Beijing 100044, China
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14
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Gayam V, Hossain MR, Khalid M, Chakaraborty S, Mukhtar O, Dahal S, Mandal AK, Gill A, Garlapati P, Ramakrishnaiah S, Mowyad K, Sherigar J, Mansour M, Mohanty S. Real-World Clinical Efficacy and Tolerability of Direct-Acting Antivirals in Hepatitis C Monoinfection Compared to Hepatitis C/Human Immunodeficiency Virus Coinfection in a Community Care Setting. Gut Liver 2019; 12:694-703. [PMID: 29938459 PMCID: PMC6254621 DOI: 10.5009/gnl18004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/27/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Background/Aims Limited data exist comparing the safety and efficacy of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) monoinfected and HCV/human immunodeficiency virus (HIV) coinfected patients in the real-world clinic practice setting. Methods All HCV monoinfected and HCV/HIV coinfected patients treated with DAAs between January 2014 and October 2017 in community clinic settings were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy, factors affecting sustained virologic response at 12 weeks (SVR12) after treatment, and adverse reactions were compared between the groups. Results A total of 327 patients were included in the study, of which 253 were HCV monoinfected, and 74 were HCV/HIV coinfected. There was a statistically significant difference observed in SVR12 when comparing HCV monoinfection and HCV/HIV coinfection (94% and 84%, respectively, p=0.005). However, there were no significant factors identified as a predictor of a reduced response. The most common adverse effect was fatigue (27%). No significant drug interaction was observed between DAA and antiretroviral therapy. None of the patients discontinued the treatment due to adverse events. Conclusions In a real-world setting, DAA regimens have lower SVR12 in HCV/HIV coinfection than in HCV monoinfection. Further studies involving a higher number of HCV/HIV coinfected patients are needed to identify real predictors of a reduced response.
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Affiliation(s)
- Vijay Gayam
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Muhammad Rajib Hossain
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Mazin Khalid
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Sandipan Chakaraborty
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Osama Mukhtar
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Sumit Dahal
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Amrendra Kumar Mandal
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Arshpal Gill
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Pavani Garlapati
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | | | - Khalid Mowyad
- Department of Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA
| | - Jagannath Sherigar
- Division of Gastroenterology and Hepatology, Department of Medicine, New York-Presbyterian Brooklyn Methodist Hospital, New York, NY, USA
| | - Mohammed Mansour
- Department of Medicine and Gastroenterology, Interfaith Medical Center, New York, NY, USA
| | - Smruti Mohanty
- Division of Gastroenterology and Hepatology, Department of Medicine, New York-Presbyterian Brooklyn Methodist Hospital, New York, NY, USA
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15
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Wang Q, Rao HY, Wei L. [Algorithmic analysis of potential drug-drug interactions using direct-acting antiviral agents and concomitant medications in chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:209-224. [PMID: 29804395 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Direct acting antiviral agents (DAAs) metabolism and pharmacokinetics of concomitant medications data were extracted and analyzed from the database of Chinese Health Insurance between 2013 and 2015. A potential drug-drug interactions (DDI) were calculated by integration of extracted data and confirmed by using Liverpool website (https: //www.hep-druginteractions.org/). A new algorithm is suggested for management of DDI between DAAs and concomitant medications.
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Affiliation(s)
- Q Wang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing 100044, China
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16
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Wang Q, Rao HY, Yu N, Gao SQ, Wei L. [Comorbidities and concomitant medication use in adult patients with chronic hepatitis C: a descriptive epidemiological analysis]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:225-232. [PMID: 29804396 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the comorbidity and concomitant medications use in adult patients with chronic hepatitis C. Methods: A descriptive epidemiological methods was carried out in adult patients with chronic hepatitis C and data from 2013 to 2015 were accessed through the China Medical Insurance database. Results: Among a chronic HCV cohort of 2 958 cases, the top five comorbidities were diabetes, hypertension, ischemic heart disease, gastroduodenitis, and co-infection with HBV and HCV. The three most common concomitant medications prescribed for mentioned comorbidities were acarbose, metformin and repaglinide (Diabetes), nifedipine, amlodipine and metoprolol (Hypertension), aspirin, nifedipine and amlodipine (Ischemic heart disease), omeprazole, pantoprazole and levolfoxacin (Gastroduodenitis), ribavirin, pegylated interferon alpha-2a and alpha-2b ( Co- infected with hepatitis B and C virus). Conclusion: The five most frequent comorbidities in adult patients with chronic hepatitis C are diabetes, hypertension, ischemic heart disease, gastroduodenitis, and co-infection with HBV and HCV. A concomitant medication use in those patients with comorbidities causes potential drug-drug interactions.
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Affiliation(s)
- Q Wang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
| | - H Y Rao
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
| | - N Yu
- Beijing Brainpower Pharma Consulting, Beijing 100021, China
| | - S Q Gao
- Beijing North Medical & Health Economics Research Center, Beijing 100021, China
| | - L Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
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Abstract
Chronic hepatitis C (CHC) has a prevalence rate of 0.43% in China and approximately 10 million chronically infected people are in urgent need of treatment. Since the beginning of 2013, pan-genotypic sofosbuvir (SOF) with its potent antiviral activity, minimal drug resistance, less drug-drug interactions and good safety has created a new era in HCV treatment. Its combination with ribavirin, in single tablet regimen with either ledipasvir or velpatasvir has been widely used in about 1.6 million patients worldwide. Furthermore, SOF-based therapy is proven to be effective and safe in serious or terminal illness such as decompensated cirrhosis, liver or kidney transplantation, HIV or HBV co-infections, bleeding disorders, intravenous drug users, adolescents, and elderly. Therefore, SOF-based regimens would fill the unmet medical needs of our patients with HCV.
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Affiliation(s)
- Q F Zhang
- Department of Infectious Diseases, the Second Hospital Affiliated to Chongqing Medical University, Chongqing 400010, China
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18
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Yang J, Rao HY. [Effectiveness and safety of direct-acting antiviral agents for treatment of patients with chronic hepatitis C virus infection]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:175-178. [PMID: 29804389 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hepatitis C is one of the major causes of liver disease worldwide. Chronic hepatitis C can cause liver fibrosis and cirrhosis leading to end-stage liver disease. Antiviral therapy can clear the virus, stop the progress of the disease, thereby reducing the incidence of advanced liver disease. This article aims to discuss the effects and safety of antiviral treatments, including direct- acting antiviral agents, on patients with chronic hepatitis C with fibrosis and compensated and decompensated liver cirrhosis.
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Affiliation(s)
- J Yang
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
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19
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Zhang XH, Gao ZL. [Impression of direct-acting antiviral agents in the treatment of recurrent hepatocellular carcinoma related to chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:179-83. [PMID: 29804390 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The treatment of chronic hepatitis C has gradually entered into the era of direct-acting antiviral agents (DAAs) from the era of pegylated interferon-α combined with ribavirin, which has a high curative effect, good tolerability, and complete patient-friendly oral form of administration. Sustained virologic response (SVR) acquired by pegylated interferon-α plus ribavirin therapy has been widely recognized by scholars in reducing the recurrence of primary liver cancer and liver cancer, especially in cirrhotic patients. The clinical application time of DAAs is short and its report is inconsistent with the increase or decrease of primary liver cancer and liver cancer recurrence. Simultaneously, the effect of SVR in people with hepatocellular carcinoma on DAAs seems to be different from those in patients without hepatocellular carcinoma. This article reviews some of the existing reports in order to increase the understanding of DAAs and liver cancer and serve the long-term benefit of clinical treatment.
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He YJ, Liu ZH, Hou JL. [Selection of direct-acting antiviral agents for chronic hepatitis C infection]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:169-72. [PMID: 29804388 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The elimination of hepatitis C virus(HCV) infection is still a long way to go. Direct-acting antiviral agents (DAAs) can make HCV completely cured by targeting various stages of its replication life cycle and meanwhile standardize and simplify the treatment. However, those relative factors may affect efficacy and safety should be considered by specialties in choosing the suitable regimens. Therefore, this article reviews various aspects of DAAs including development history, factors correlated with efficacy and safety, therapeutic regimens domestic listed and approved.
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Liu X, Gao YH, Niu JQ. [Hepatitis C-related hepatocellular carcinoma and the treatment with direct-acting antiviral agents]. Zhonghua Gan Zang Bing Za Zhi 2019; 25:944-947. [PMID: 29325299 DOI: 10.3760/cma.j.issn.1007-3418.2017.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
With the wide use of direct-acting antiviral agents (DAAs), more and more patients with chronic hepatitis C achieve sustained virological response; however, no consensus has been reached on the application of DAAs in the treatment of hepatitis C virus-related hepatocellular carcinoma (HCC). This article summarizes and evaluates related issues in this field, including whether antiviral therapy with DAAs in patients with hepatitis C can increase the incidence or recurrence rate of HCC, as well as whether DAAs can be used for hepatitis C in HCC patients after antitumor treatment and the efficacy of DAAs in such patients.
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Affiliation(s)
- X Liu
- Department of Hepatology, First Hospital of Jilin University, Changchun 130021, China
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Abstract
The use of direct-acting antiviral agents (DAAs) in the treatment of chronic hepatitis C and its approval in China applying the goal proposed by the World Health Organization is an important step towards eliminating viral hepatitis as public health threat by 2030. However, we also need to create a model that is suitable and short duration therapy for the Chinese patients. On the other hand, it is also essential to study the reverse hepatic fibrosis and the emerging problems of hepatitis C-related liver cancer.
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Affiliation(s)
- L Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, China Liver Health, Beijing 100044, China
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23
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Zhu F, Zhang QY, Zhang DZ. [Clinical value of pegylated interferon-α plus ribavirin-based therapy in antiviral treatment of chronic hepatitis C in China]. Zhonghua Gan Zang Bing Za Zhi 2019; 26:173-174. [PMID: 29807402 DOI: 10.3760/cma.j.issn.1007-3418.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Chronic hepatitis C virus (HCV) infection is one of the most common causes of liver cirrhosis and hepatocellular carcinoma in China. The older standard treatment regimen for chronic hepatitis C was the pegylated interferon-alfa plus ribavirin(PR). Now newer oral medications called direct antiviral agents (DAAs) has been gradually changed to PR-based DAAs and interferon-free, oral DAAs; making chronic hepatitis C a curable disease. This article intends to expound the advantages and disadvantages of PR-based therapy and provide reference for the treatment of chronic hepatitis C.
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Affiliation(s)
- F Zhu
- Department of Infectious Diseases, the Second Hospital Affiliated to Chongqing Medical University, Chongqing 400010, China
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Jin S, Sun YH, Peng Z, Zhang DZ, Ren H. [Summary of the 10th Conference on Hot Issues and Academic Problems of Antiviral Therapy in Chronic Viral Hepatitis & the Second Annual Meeting of Liver Cancer Group of Chinese Society of Hepatology of Chinese Medical Association]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:71-72. [PMID: 30685930 DOI: 10.3760/cma.j.issn.1007-3418.2019.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- S Jin
- Editorial Board of the Chinese Journal of Hepatology, Institute for Viral Hepatitis, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
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Li JP, Feng WT, Xie ZW, Xu M, Zhang JZ, Guan YJ. [Real-world study of daclatasvir and asunaprevir combination in Chinese patients with HCV genotype 1b infection]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:951-954. [PMID: 30669790 DOI: 10.3760/cma.j.issn.1007-3418.2018.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- J P Li
- Department of Hepatology, Guangzhou No.8 People Hospital, Guangzhou 510060, China
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Wei L, Cheng J, Luo J, Li ZP, Duan JL, Hou JD, Jia MX, Zhang Y, Huang Q, Xie GJ, Wang DL, Yang W, Zhao CY, Zhao G, Tang SM, Lin GZ, Gong JJ, Niu ZL, Gao JF, Sarah KB, Linda F, Niloufar M, Wang Y, Wang J. Efficacy and safety of paritaprevir/ritonavir/ombitasvir combined with dasabuvir in non-cirrhotic Asian adult patients with newly diagnosed and treated chronic HCV genotype 1b infection: a randomized, double-blind, placebo-controlled study - China data. Zhonghua Gan Zang Bing Za Zhi. 2018;26:359-364. [PMID: 29996204 DOI: 10.3760/cma.j.issn.1007-3418.2018.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To evaluate the safety and efficacy of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) 25/150/100 mg once daily combined with dasabuvir 250mg, twice daily in non-cirrhotic Chinese adult patients with newly diagnosed and treated chronic HCV genotype 1b infection. Methods: A randomized, double-blind, placebo-controlled, multicenter phase 3 clinical trial was conducted in mainland China, Korea, and Taiwan.Safety and efficacy of OBV/PTV/r plus DSV administered for 12 weeks were evaluated in a newly diagnosed and treated (interferon alpha /pegylated interferon alpha) and ribavirin non-cirrhotic adults with chronic HCVgenotype 1b infection. Patients randomly received OBV/PTV/r plus DSV for 12 weeks (Group A), or placebo for 12 weeks (Group B) followed by an open-label phase of OBV/PTV/r plus DSV for 12 weeks. Sustained response (SVR12) rate obtained at 12 weeks and (SVR24) 24 weeks after discontinuation of treatment, and the incidence of adverse events and laboratory abnormalities after double-blind and open-label phase treatment were assessed. Results: A total of 410 cases of Chinese patients were included and randomly assigned to group A and B (with 205 cases in each group) in a 1:1 ratio. The rates of SVR12 and SVR24 were 99% (95% CI: 94.8% - 99.8%) in the newly diagnosed patients in group A (205 patients) and the rates of SVR12 and SVR24 were 100% in treated patients (95% CI: 96.3% - 100%). Different baseline characteristics had no effect on SVR12 and SVR24 rates. Most of the adverse events occurred were mild, asymptomatic, and≥ 3 laboratory abnormalities during treatment were rare, including elevation of alanine aminotransferase (2 cases in double-blind stage A group), aspartate aminotransferase (Double-blind stage A (3 cases) and total bilirubin (1 case in open-label phase B group); however, those mild adverse events could be recovered after drug withdrawal or discontinuation. only1 person discontinued drugs due to adverse events (Group B, open-label phase). Conclusion: The 12 weeks treatment course of OBV/PTV/r combined with DSV produced 99% ~ 100% rates of SVR12 and SVR24 in non-cirrhotic Asian adult patients with newly diagnosed and treated chronic HCV genotype 1b infection, and the tolerance and safety were good.
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Lee HW, Yoo KY, Won JW, Kim HJ. Direct Acting Antiviral Agents in Korean Patients with Chronic Hepatitis C and Hemophilia Who Are Treatment-Naïve or Treatment-Experienced. Gut Liver 2018; 11:721-727. [PMID: 28874040 PMCID: PMC5593335 DOI: 10.5009/gnl17209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/24/2017] [Accepted: 06/24/2017] [Indexed: 12/21/2022] Open
Abstract
Background/Aims Chronic hepatitis C (CHC) is a major comorbidity in patients with hemophilia. Methods Patients (n=30) were enrolled between September 2015 and April 2016. Twenty-six patients were genotype 1 (1b, n=21; 1a, n=5) and four patients were genotype 2a/2b. Among 21 patients with genotype 1b, Y93H resistance-associated variants (RAVs) were detected in three patients (14.3%). We evaluated sustained virologic response (SVRs) at 12 weeks, as well as relapse and safety. Results Five patients with genotype 1a and three patients with genotype 1b (RAV positive) received ledipasvir/sofosbuvir for 12 weeks. SVR12 rate was 100% (8/8). Eleven patients with genotype 1b were treatment-naïve and received daclatasvir plus asunaprevir for 24 weeks. SVR12 rate was 91% (10/11). One patient experienced viral breakthrough without RAV at 12 weeks. Seven treatment-experienced patients with genotype 1b received daclatasvir plus asunaprevir for 24 weeks. SVR12 rate was 85.7% (6/7). One patient experienced viral breakthrough with RAV (L31M, Y93H) at 12 weeks. Four patients with genotype 2a/2b received sofosbuvir plus ribavirin for 12 weeks. SVR12 rate was 100% (4/4). No serious adverse event-related discontinuations were noted. Conclusions New direct acting antiviral treatment achieved high SVRs rates at 12 weeks in CHC patients with hemophilia without serious adverse events.
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Affiliation(s)
- Hyun Woong Lee
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ki Young Yoo
- Department of Pediatrics, Korea Hemophilia Foundation Hospital, Seoul, Korea
| | - Joung Won Won
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyung Joon Kim
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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Feng B, Shang J, Wu SH, Chen H, Han Y, Li YQ, Zhang DZ, Zhao LF, Wei SF, Mao Q, Yin CB, Han T, Wang MR, Chen SJ, Li J, Xie Q, Zhen Z, Gao ZL, Zhang YX, Gong GZ, Yang DL, Pan C, Sheng JF, Tang H, Ning Q, Shi GF, Niu JQ, Luo GH, Sun YT, You H, Wang GQ, Zhang LL, Peng J, Zhang Q, Liu JJ, Chen CW, Chen XY, Zhao W, Wang RH, Sun L, Wei L. [Efficacy and safety of pegylated interferon α-2b injection (Y shape, 40 kD) in treatment of patients with genotype 1/6 chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:187-194. [PMID: 28482405 DOI: 10.3760/cma.j.issn.1007-3418.2017.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion: In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.
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Affiliation(s)
- B Feng
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
| | - J Shang
- Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - S H Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Lanzhou University, Lanzhou 730000, China
| | - Y Han
- Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Y Q Li
- Department of Infectious Diseases, 302 Military Hospital, Beijing 100039, China
| | - D Z Zhang
- Department of Infectious Diseases, Institute for Viral Hepatitis, Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
| | - L F Zhao
- Department of Infectious Diseases, The First Affiliated Hospital of Shanxi University, Taiyuan 030001, China
| | - S F Wei
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
| | - Q Mao
- Department of Infectious Disease, Southeast Hospital, Third Military Medical University, Chongqing 400038, China
| | - C B Yin
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou 510060, China
| | - T Han
- Department of Hepatology, Tianjin Third Central Hospital, Tianjin Medical University, Tianjin 300170, China
| | - M R Wang
- Institute of Liver Disease, Nanjing 81 Hospital, Nanjing 210002, China
| | - S J Chen
- Department of Hepatology, Jinan Infectious Disease Hospital, Jinan 250021, China
| | - J Li
- Department of Infectious Diseases, Jiangsu Provincial People's Hospital, Nanjing 210029, China
| | - Q Xie
- Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Z Zhen
- Department of Infectious Diseases, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang 050051, China
| | - Z L Gao
- Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - Y X Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi 830054, China
| | - G Z Gong
- Department of Infectious Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - D L Yang
- Department of Infectious Disease, Institute of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - C Pan
- Department of Hepatology, Fuzhou Infectious Disease Hospital, Fuzhou, 350025, China
| | - J F Sheng
- The First Affiliated Hospital of Zhengjiang University, Hangzhou 310003, China
| | - H Tang
- Department of Infectious Diseases, Sichuan University West China Hospital, Chengdu 610041, China
| | - Q Ning
- Department of Infectious Disease, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - G F Shi
- Department of Infectious Diseases, Huashan Hospital, Shanghai 200040, China
| | - J Q Niu
- Department of Infectious Diseases, The First Affiliated Hospital of Jilin University, Changchun 130062, China
| | - G H Luo
- Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical Universtiy, Nanning 530021, China
| | - Y T Sun
- Department of Infectious Diseases, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China
| | - H You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - G Q Wang
- Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
| | - L L Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanchang University, Nanchang 360102, China
| | - J Peng
- Department of Infectious Diseases, Nangfang Hospital, Southern Medical University, Guangzhou 510510, China
| | - Q Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China
| | - J J Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - C W Chen
- Nanjing Military Command Liver Disease Research Center, Shanghai 200000, China
| | - X Y Chen
- Hepatology Department, Youan Hospital, Capital Medical University, Beijing 100069, China
| | - W Zhao
- Department of Hepatology, The Second Affiliated Hospital of the Southeast University, Nanjing 210003, China
| | - R H Wang
- Xiamen Amoytop Biotech Co., Ltd, Xiamen, 361022, China
| | - L Sun
- Xiamen Amoytop Biotech Co., Ltd, Xiamen, 361022, China
| | - L Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing 100044, China
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Luo BF, Wei L. [Recent advances in the treatment of hepatitis C in 2016]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:175-80. [PMID: 28482403 DOI: 10.3760/cma.j.issn.1007-3418.2017.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
It has been rapidly developed in treatment of chronic hepatitis C from the past few years. Here we summarize the progress in chronic hepatitis C treatment in 2016. We introduce the pan-genotypic regimens with short-duration, the efficacy of DAA regimens in difficult-to-treat population, the influence on hepatocellular carcinoma, decompensation of liver cirrhosis, liver fibrosis and liver transplantation, the safety of DAA regimens in special population, information from real-world studies and data from China.
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Oh IS, Won JW, Kim HJ, Lee HW. Clinical implication of serum uric acid level in pegylated interferon and ribavirin combination therapy for chronic hepatitis C infection. Korean J Intern Med 2017; 32:1010-1017. [PMID: 28797159 PMCID: PMC5668402 DOI: 10.3904/kjim.2016.405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/08/2017] [Accepted: 05/22/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND/AIMS Combined treatment of pegylated interferon-α (PEG-IFN) and ribavirin (RBV) has long been accepted as the standard treatment for chronic hepatitis C virus (HCV) infection. Many predictive factors for treatment response have been identified. The aim of this study was to evaluate the efficacy and safety of combined PEG-IFN plus RBV and to examine the value of serum uric acid as a predictive factor in the treatment of chronic hepatitis C. METHODS A total of 74 patients chronically infected with HCV were enrolled between December 2004 and June 2009. Patients received subcutaneous PEG-IFN (α-2a: 180 μg once a week) in combination with RBV (1,000 to 1,200 mg daily depending on body weight). We evaluated treatment responses represented by early virologic response (EVR), end-of-treatment response (ETR), sustained virologic response (SVR), and relapse, as well as diverse adverse events. Various viral and host features were also assessed to clarify factors associated with treatment response. RESULTS During treatment, EVR was achieved in 26 patients (26/33, 78.8%) with HCV genotype 1. ETR and SVR were achieved in 59 (77.6%) and 56 patients (73.6%), respectively, across all genotypes. Genotype 2/3, lower HCV RNA, and lower uric acid were associated with higher SVR. CONCLUSIONS The treatment response to combination therapy with PEG-IFN plus RBV was effective, especially in genotype 2/3. Uric acid might be useful as a predictive factor for response to therapy for chronic hepatitis.
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Affiliation(s)
| | | | | | - Hyun Woong Lee
- Correspondence to Hyun Woong Lee, M.D. Department of Internal Medicine, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea Tel: +82-2-6299-1417 Fax: +82-2-6299-1137 E-mail:
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Shin SR, Kim YS, Lim YS, Lee JS, Lee JW, Kim SM, Jeong SH, Sohn JH, Lee MS, Park SH. Clinical Characteristics and Treatment Outcome of Peginterferon Plus Ribavirin in Patients Infected with Genotype 6 Hepatitis C Virus in Korea: A Multicenter Study. Gut Liver 2017; 11:270-275. [PMID: 27728965 PMCID: PMC5347652 DOI: 10.5009/gnl16163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/12/2016] [Accepted: 05/12/2016] [Indexed: 12/29/2022] Open
Abstract
Background/Aims Because of the limited geographic distribution, there have been insufficient data regarding hepatitis C virus (HCV) genotype 6 in Korea. This study aimed to investigate the clinical characteristics and available treatment outcomes of patients with genotype 6 HCV in Korea. Methods From 2004 to 2014, data were collected from Korean patients infected with genotype 6 HCV in eight hospitals. Results Thirty-two patients had genotype 6 HCV. The median age was 44 years, and 6c was the most common subtype. The baseline median alanine transaminase level was 88 (21 to 1,019) IU/mL, and the HCV RNA level was 1,405,000 (96,500 to 28,844,529) IU/mL. Twenty-five patients were treated with peginterferon (PEG-IFN) and ribavirin. Three follow-up losses occurred. Additionally, 13 patients attained a sustained virologic response (SVR), seven patients relapsed, and two patients exhibited a null response. The SVR rates were 40% and 75% for the 24- and more than 48-week treatments, respectively, and five of the six patients who achieved a rapid virologic response (RVR) attained a SVR. Conclusions Korean patients infected with genotype 6 HCV are relatively young, and 6c is the most common subtype. When treated with PEG-IFN and ribavirin, the SVR rate was 52%. Similar to other genotypes, a longer duration of treatment and attainment of RVR are important for SVR.
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Affiliation(s)
- Su Rin Shin
- Health Care Center, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.,Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Young-Seok Lim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - June Sung Lee
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jin Woo Lee
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
| | - Sun Myung Kim
- Department of Internal Medicine, Gimpo Woori Hospital, Gimpo, Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Myung Seok Lee
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Sang Hoon Park
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
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Belli LS, Duvoux C, Berenguer M, Berg T, Coilly A, Colle I, Fagiuoli S, Khoo S, Pageaux GP, Puoti M, Samuel D, Strazzabosco M. ELITA consensus statements on the use of DAAs in liver transplant candidates and recipients. J Hepatol 2017; 67:585-602. [PMID: 28323126 DOI: 10.1016/j.jhep.2017.03.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/01/2017] [Accepted: 03/09/2017] [Indexed: 02/07/2023]
Abstract
The advent of safe and highly effective direct-acting antiviral agents (DAAs) has had huge implications for the hepatitis C virus (HCV) transplant field, and changed our management of both patients on the waiting list and those with HCV graft re-infection after liver transplantation (LT). When treating HCV infection before LT, HCV re-infection of the graft can be prevented in nearly all patients. In addition, some candidates show a remarkable clinical improvement and may be delisted. Alternatively, HCV infection can be treated post-LT either soon after the transplant, taking advantage of the removal of the infected native liver, or at the time of disease recurrence, as was carried out in the past. In either case, some DAAs have a limited use because of their drug to drug interactions with various immunosuppressants as well as the many other drugs liver transplant recipients are often prescribed. In addition, some DAAs should be avoided in case of severe renal failure, which is not an unusual complication after LT. The present document provides a series of consensus statements on the LT issues that have not been extensively addressed previously. These statements have been developed to support physicians and other stakeholders in charge of LT candidates and recipients when deciding to treat HCV, especially in difficult situations.
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Kwo PY, Poordad F, Asatryan A, Wang S, Wyles DL, Hassanein T, Felizarta F, Sulkowski MS, Gane E, Maliakkal B, Overcash JS, Gordon SC, Muir AJ, Aguilar H, Agarwal K, Dore GJ, Lin CW, Liu R, Lovell SS, Ng TI, Kort J, Mensa FJ. Glecaprevir and pibrentasvir yield high response rates in patients with HCV genotype 1-6 without cirrhosis. J Hepatol 2017; 67:263-71. [PMID: 28412293 DOI: 10.1016/j.jhep.2017.03.039] [Citation(s) in RCA: 229] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 03/16/2017] [Accepted: 03/27/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV) therapy that is highly efficacious, pangenotypic, with a high barrier to resistance and short treatment duration is desirable. The efficacy and safety of 8- and 12-week treatments with glecaprevir (ABT-493; NS3/4A protease inhibitor) and pibrentasvir (ABT-530; NS5A inhibitor) were evaluated in non-cirrhotic patients with chronic HCV genotype 1-6 infection. METHODS SURVEYOR-I and SURVEYOR-II were phase II, open-label, multicenter, dose-ranging trials including patients with chronic HCV genotype 1-6 infection who were either previously untreated or treated with pegylated interferon plus ribavirin. Patients received once-daily glecaprevir plus pibrentasvir at varying doses with or without ribavirin for 8 or 12weeks. The primary efficacy endpoint was the percentage of patients with a sustained virologic response at post-treatment week 12 (SVR12). RESULTS Of the 449 patients who received varying doses of glecaprevir plus pibrentasvir, 25%, 29%, 39%, and 8% had HCV genotype 1, 2, 3, and 4-6 infection, respectively. Twelve-week treatment achieved SVR12 in 97-100%, 96-100%, 83-94%, and 100% in genotypes 1, 2, 3, and 4-6, respectively. Eight-week treatment with 300mg glecaprevir plus 120mg pibrentasvir in genotype 1-, 2-, or 3-infected patients yielded 97-98% SVR12 with no virologic failures. Three (0.7%) patients discontinued treatment due to adverse events; most events were mild (grade 1) in severity. No post-nadir alanine aminotransferase elevations were observed. CONCLUSIONS Glecaprevir plus pibrentasvir was well tolerated and achieved high sustained virologic response rates in HCV genotypes 1-6-infected patients without cirrhosis following 8- or 12-week treatment durations. LAY SUMMARY The combination of direct-acting antivirals glecaprevir and pibrentasvir comprise a once-daily, all-oral, pangenotypic treatment for HCV genotype 1-6 infection. This article describes results from two phase II trials investigating a range of doses at treatment durations of 8 or 12weeks in 449 patients without cirrhosis. Efficacy of the optimal dose, as determined by rates of sustained virologic response at post-treatment week 12, ranged from 92%-100%; treatment was well tolerated and significant laboratory abnormalities were rare. CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifiers: NCT02243280 and NCT02243293. http://www.clinicaltrials.gov/show/NCT02243280, http://www.clinicaltrials.gov/show/NCT01939197.
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Fan JH, Xiang MQ, Li QL, Shi HT, Guo JJ. PNPLA3 rs738409 Polymorphism Associated with Hepatic Steatosis and Advanced Fibrosis in Patients with Chronic Hepatitis C Virus: A Meta-Analysis. Gut Liver 2017; 10:456-63. [PMID: 26419236 PMCID: PMC4849700 DOI: 10.5009/gnl15261] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background/Aims The recognition of a correlation between patatin-like phospholipase domain containing-protein 3 (PNPLA3) rs738409 (C>G) and the severity of liver steatosis or fibrosis in chronic hepatitis C (CHC) has not reached a consensus. This meta-analysis sought to investigate with accuracy the association between the PNPLA3 rs738409 (C>G) polymorphism and liver steatosis and advanced fibrosis in CHC patients. Methods We performed a comprehensive literature search from the PubMed, Embase, Web of Science, and Google Scholar databases up to December 31, 2014. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Statistical analyses were performed using Stata 12.0 software. Results The meta-analysis revealed the severity of liver fibrosis was significantly higher in CHC patients with PNPLA3 rs738409 GG in Caucasians (versus CC+CG: OR, 2.29; 95% CI, 1.57 to 3.35; p<0.05) but not Asian populations. In Caucasians, liver steatosis was also more severe in CHC patients with rs738409 GG (versus CC+CG; OR, 4.33; 95% CI, 2.59 to 7.22; p<0.05). The sensitivity analysis indicated the results of this meta-analysis were stable and no publication bias was detected. Conclusions PNPLA3 rs738409 (C>G) was associated with the risk of both advanced liver fibrosis and steatosis in patients with CHC, especially among Caucasian populations.
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Affiliation(s)
- Jia-Hao Fan
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming-Que Xiang
- Department of Infectious Diseases, The Ninth People's Hospital of Chongqing, Chongqing, China
| | - Qing-Ling Li
- Institute of Life Sciences, Chongqing Medical University, Chongqing, China
| | - Hong-Tao Shi
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jin-Jun Guo
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Lee HW, Chon YE, Kim SU, Kim BK, Park JY, Kim DY, Ahn SH, Jung KS, Park YN, Han KH. Predicting Liver-Related Events Using Transient Elastography in Chronic Hepatitis C Patients with Sustained Virological Response. Gut Liver 2017; 10:429-36. [PMID: 26347515 PMCID: PMC4849697 DOI: 10.5009/gnl15021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background/Aims Few studies have investigated prognostic factors for the development of liver-related events (LREs) in patients with chronic hepatitis C (CHC) who achieve sustained virological response (SVR). Methods We analyzed 190 patients with CHC who achieved SVR after treatment with pegylated interferon (peg-IFN) plus ribavirin. LREs were defined as any complications related to cirrhosis, hepatocellular carcinoma (HCC), or liver-related mortality. Results The mean age was 54.1 years, and 84 of the patients (44.2%) were male. The mean liver stiffness (LS) value at SVR was 7.1±5.4 kPa. During the follow-up period (median, 43.0 months), LREs occurred in 10 patients (5.3%; HCC in eight patients, ascites in one patient, and liver-related mortality in one patient). By multivariate Cox regression analysis, age, α-fetoprotein level, and LS value were independent predictors for LRE development (all p<0.05). Patients with LS values ≥7.0 kPa had a greater risk (hazard ratio, 9.472; 95% confidence interval, 1.018 to 88.126; p=0.048) for LRE development compared to those with LS values <7.0 kPa. Conclusions The LS value at SVR is useful for predicting LRE development in CHC patients who achieve SVR after treatment with peg-IFN plus ribavirin. Thus, LRE surveillance strategies might be optimized according to the LS values at SVR, even with complete viral eradication.
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Affiliation(s)
- Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Eun Chon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Project for MedicalScience, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Sik Jung
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Nyun Park
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 Project for MedicalScience, Yonsei University College of Medicine, Seoul, Korea
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Hua Z, Gu XB, Dai YP, Guo XY, Wu HY, Zhang B, Xu W, Wang Z, Deng J, Ju F. [Correlation between viral load and expression of programmed death-1 on the surface of T follicular helper cells in patients with chronic hepatitis C]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:377-9. [PMID: 28763846 DOI: 10.3760/cma.j.issn.1007-3418.2017.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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37
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Wróblewska A, Bernat A, Woziwodzka A, Markiewicz J, Romanowski T, Bielawski KP, Smiatacz T, Sikorska K. Interferon lambda polymorphisms associate with body iron indices and hepatic expression of interferon-responsive long non-coding RNA in chronic hepatitis C. Clin Exp Med 2017; 17:225-232. [PMID: 27125837 PMCID: PMC5403869 DOI: 10.1007/s10238-016-0423-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 04/18/2016] [Indexed: 12/21/2022]
Abstract
Single nucleotide polymorphisms (SNPs) within DNA region containing interferon lambda 3 (IFNL3) and IFNL4 genes are prognostic factors of treatment response in chronic hepatitis C (CHC). Iron overload, frequently diagnosed in CHC, is associated with unfavorable disease course and a risk of carcinogenesis. Its etiology and relationship with the immune response in CHC are not fully explained. Our aim was to determine whether IFNL polymorphisms in CHC patients associate with body iron indices, and whether they are linked with hepatic expression of genes involved in iron homeostasis and IFN signaling. For 192 CHC patients, four SNPs within IFNL3-IFNL4 region (rs12979860, rs368234815, rs8099917, rs12980275) were genotyped. In 185 liver biopsies, histopathological analyses were performed. Expression of five mRNAs and three long non-coding RNAs (lncRNAs) was determined with qRT-PCR in 105 liver samples. Rs12979860 TT or rs8099917 GG genotypes as well as markers of serum and hepatocyte iron overload associated with higher activity of gamma-glutamyl transpeptidase and liver steatosis. The presence of two minor alleles in any of the tested SNPs predisposed to abnormally high serum iron concentration and correlated with higher hepatic expression of lncRNA NRIR. On the other hand, homozygosity in any major allele associated with higher viral load. Patients bearing rs12979860 CC genotype had lower hepatic expression of hepcidin (HAMP; P = 0.03). HAMP mRNA level positively correlated with serum iron indices and degree of hepatocyte iron deposits. IFNL polymorphisms influence regulatory pathways of cellular response to IFN and affect body iron balance in chronic hepatitis C virus infection.
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Affiliation(s)
- Anna Wróblewska
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology UG and MUG, Abrahama 58, 80-307, Gdańsk, Poland
| | - Agnieszka Bernat
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology UG and MUG, Abrahama 58, 80-307, Gdańsk, Poland
| | - Anna Woziwodzka
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology UG and MUG, Abrahama 58, 80-307, Gdańsk, Poland
| | - Joanna Markiewicz
- Department of Infectious Diseases, Pomeranian Center of Infectious Diseases, Smoluchowskiego 18, 80-214, Gdańsk, Poland
| | - Tomasz Romanowski
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology UG and MUG, Abrahama 58, 80-307, Gdańsk, Poland
| | - Krzysztof P Bielawski
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology UG and MUG, Abrahama 58, 80-307, Gdańsk, Poland
| | - Tomasz Smiatacz
- Department of Infectious Diseases, Medical University of Gdansk, Smoluchowskiego 18, 80-214, Gdańsk, Poland
| | - Katarzyna Sikorska
- Department of Infectious Diseases, Medical University of Gdansk, Smoluchowskiego 18, 80-214, Gdańsk, Poland.
- Department of Tropical Medicine and Epidemiology, Medical University of Gdansk, Powstania Styczniowego 9b, 81-519, Gdynia, Poland.
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Talal AH, Chen Y, Zeremski M, Zavala R, Sylvester C, Kuhns M, Brown LS, Markatou M, Cloherty GA. Hepatitis C virus core antigen: A potential alternative to HCV RNA testing among persons with substance use disorders. J Subst Abuse Treat 2017; 78:37-42. [PMID: 28554601 DOI: 10.1016/j.jsat.2017.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/12/2017] [Accepted: 04/17/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The hepatitis C virus (HCV) core antigen (HCVcAg) may be an alternative diagnostic method to HCV RNA especially in populations such as substance users, the homeless or in resource-limited settings. AIMS To evaluate performance of HCVcAg test in patients with opioid use disorder (OUD) on methadone in order to document its performance characteristics in the target population and to ensure that its specificity remains consistent across different populations. METHODS HCVcAg levels from 109 methadone-maintained patients were compared to HCV RNA levels. RESULTS Mean age was 53.8±7.8years, 59.6% were male, 68.8% African American, and 44% HCV-infected. HCVcAg was detectable in 47 of 48 HCV-infected, and undetectable in all HCV RNA negative patients. The HCVcAg assay had sensitivity of 97.9% and specificity of 100%. Correlation with HCV RNA levels was excellent (r=0.88, 95% CI 0.76; 0.95, p<0.01). CONCLUSION HCVcAg has excellent performance for the diagnosis of HCV infection in patients with OUD on methadone.
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Affiliation(s)
- Andrew H Talal
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA; Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA; START Treatment & Recovery Centers, Brooklyn, NY, USA.
| | - Yang Chen
- Department of Biostatistics, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Marija Zeremski
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, USA.
| | | | | | - Mary Kuhns
- Abbott Diagnostics, Inc, Abbott Park, IL, USA
| | | | - Marianthi Markatou
- Department of Biostatistics, University at Buffalo, State University of New York, Buffalo, NY, USA
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Rei A, Rocha M, Pedroto I. Health-Related Quality of Life in Portuguese Patients with Chronic Hepatitis C. GE Port J Gastroenterol 2016; 24:68-78. [PMID: 28848786 DOI: 10.1159/000450875] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 07/26/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Chronic hepatitis C virus (HCV) infection impacts multiple health and psychosocial dimensions and encompasses a significant overall burden as it progresses to advanced stages of hepatic disease. AIMS To evaluate for the first time health-related quality of life (HRQoL) of a subset of Portuguese adult patients with chronic hepatitis C using the Portuguese versions of generic, Short-Form 12 Health Survey (SF-12v2), and disease-specific, Chronic Liver Disease Questionnaire (CLDQ), instruments; to assess psychometric properties of CLDQ, Portuguese version. METHODS HRQoL was evaluated in Portuguese adult outpatients with chronic hepatitis C attending the Hepatology Clinic at Centro Hospitalar do Porto, using SF-12v2 and CLDQ. This transversal study was conducted between April and October 2015. RESULTS Eighty outpatients with chronic hepatitis C were enrolled, with mean age 57 years (standard deviation 11), 67.5% male, all Caucasian, 76.3% diagnosed for >10 years, 66.3% with C virus genotype 1, 65.0% with hepatic cirrhosis (94.2% of which Child-Pugh A), and 46.3% under current antiviral treatment. For CLDQ internal consistency, Cronbach's α was 0.88; for construct validity, correlations ranged from 0.36 to 0.80 (p < 0.01). Mean CLDQ scores ranged from 4.25 (Worry) to 5.78 (Abdominal Symptoms). Lower scores were observed for Worry, Fatigue, and Emotional Function domains. Statistically significant differences were found in median values of Worry (CLDQ) and Role Emotional (SF-12) (p < 0.05) for "current antiviral treatment," with higher scores for patients that concluded therapy. CONCLUSION HRQoL was negatively affected in several domains in Portuguese patients with chronic hepatitis C; oral antiviral treatment correlated with better quality of life, assuring its benefits on this population; the CLDQ Portuguese version revealed adequate psychometric properties, and was useful in assessing quality of life in Portuguese HCV patients.
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Affiliation(s)
- Andreia Rei
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Medical College, University of Porto (UP), Porto, Portugal
| | - Marta Rocha
- Gastroenterology Department, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal
| | - Isabel Pedroto
- Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Medical College, University of Porto (UP), Porto, Portugal.,Gastroenterology Department, Hospital de Santo António (HSA), Centro Hospitalar do Porto (CHP), Porto, Portugal
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Abstract
Peg-interferon and ribavirin has been the standard therapy of chronic hepatitis C for the past 15 years in Korea. However, the treatment paradigm is changing. Direct acting agents (DAAs) are oral pills that can be easily taken. In addition, DAAs are more effective and have less adverse reactions compared to the previously used drugs. Chronic hepatitis C is hard to treat because the virus is error-prone virus. Host immunity is helpless against the hepatitis C virus since it evades the host immunity through various complex mechanisms. There are 6 genotypes. Quasispecies can co-exist even in the same patients. The treatment strategy is based on the combination of the individual drug corresponding to each step of viral replication process. NS5B nucleosides are the most powerful and effective drug available until now. Other drugs with different mechanisms of action can be used to provide synergy. NS5A and NS5B inhibition drugs currently belong to the leading group amongst many DAAs. These drugs will soon be available in Korea. We have to know the merits and adverse drug reactions of the new drug.
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Affiliation(s)
- Hee Bok Chae
- Department of Internal Medicine, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Korea
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Hwang Y, Kim W, Kwon SY, Yu HM, Kim JH, Choe WH. Incidence of and risk factors for thyroid dysfunction during peginterferon α and ribavirin treatment in patients with chronic hepatitis C. Korean J Intern Med 2015; 30:792-800. [PMID: 26552454 PMCID: PMC4642008 DOI: 10.3904/kjim.2015.30.6.792] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/22/2014] [Accepted: 09/18/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Thyroid dysfunction (TD) is more likely to occur in patients with chronic hepatitis C (CHC) and is particularly associated with interferon (IFN) treatment. The purpose of this study was to investigate the incidence, outcomes, and risk factors for TD during pegylated interferon (PEG-IFN) and ribavirin (RBV) combined therapy in patients with CHC. METHODS A total of 242 euthyroid patients with CHC treated with PEG-IFN/RBV were included. Thyroid function and autoantibodies were measured at baseline, and virologic response and thyroid function were assessed every 3 months during therapy. RESULTS TD developed in 67 patients (27.7%) during the PEG-IFN/RBV treatment. The types of TD were subclinical hypothyroidism (50.7%), hypothyroidism (14.9%), thyroiditis (11.9%), subclinical hyperthyroidism (10.4%), and hyperthyroidism (10.4%). Most of the patients with TD recovered spontaneously; however, seven patients (10.4%) needed thyroid treatment. The sustained virological response rate was higher in patients with TD than those without (65.7% vs. 49.1%, p = 0.02). Baseline thyroid stimulating hormone (TSH) concentrations (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.96 to 8.77; p < 0.001), presence of the thyroid peroxidase antibody (OR, 8.81; 95% CI, 1.74 to 44.6; p = 0.009), and PEG-IFNα-2b (OR, 3.01; 95% CI, 1.43 to 6.39; p = 0.004) were independent risk factors for the development of TD. CONCLUSIONS TD developed in 27.7% of patients with CHC during PEG-IFN/RBV treatment, and 10.4% of these patients needed thyroid treatment. TD is associated with a favorable virologic response to PEG-IFN/RBV. Assessment of TSH and thyroid autoantibodies at baseline and close monitoring of thyroid function during PEG-IFN/RBV therapy are necessary for early detection and management of IFN-induced TD.
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Affiliation(s)
- Yong Hwang
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Won Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - So Young Kwon
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Correspondence to So Young Kwon, M.D. Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-5027 Fax: +82-2-2030-5029 E-mail:
| | - Hyung Min Yu
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jeong Han Kim
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Won Hyeok Choe
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
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Cho HC, Gwak GY, Paik YH, Choi MS, Lee JH, Koh KC, Yoo BC, Paik SW. Pegylated interferon and ribavirin in the retreatment of chronic hepatitis C in Korea. Gut Liver 2013; 7:585-93. [PMID: 24073317 PMCID: PMC3782674 DOI: 10.5009/gnl.2013.7.5.585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 02/14/2013] [Accepted: 02/25/2013] [Indexed: 11/19/2022] Open
Abstract
Background/Aims Pegylated interferon (peginterferon) and ribavirin is the current standard therapy for chronic hepatitis C. The aims of this study were to evaluate the efficacy of peginterferon and ribavirin and to identify predictors of a sustained virological response (SVR) to the retreatment of chronic hepatitis C in Korea. Methods The clinical records of 91 patients with chronic hepatitis C who were retreated with peginterferon and ribavirin were retrospectively analyzed. None of the patients had previously attained a SVR, and the patients were categorized according to their previous responses (nonresponder, relapser, or inadequate treatment) to conventional interferon/ribavirin. Results The overall SVR rate was 54.9%. Independent predictors of a SVR were genotypes 2 and 3, relapse, an adherence to peginterferon of over 80%, and an early virological response (EVR). For genotype 1 patients, an adherence to peginterferon of over 80% was an independent predictor of a SVR. Conclusions Peginterferon and ribavirin therapy is effective for the retreatment of Korean chronic hepatitis C patients who have failed interferon/ribavirin, especially in patients with genotypes 2 and 3, relapse, an adherence to peginterferon over 80%, and an EVR. For genotype 1 patients, retreatment was effective in patients with an adherence to peginterferon over 80%.
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Affiliation(s)
- Hyun Chin Cho
- Division of Gastroenterology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
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Ahmadi-Motamayel F, Vaziri S, Roshanaei G. Knowledge of General Dentists and Senior Dental Students in Iran about Prevention of Infective Endocarditis. Chonnam Med J 2012; 48:15-20. [PMID: 22570810 PMCID: PMC3341432 DOI: 10.4068/cmj.2012.48.1.15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 04/09/2012] [Indexed: 11/11/2022] Open
Abstract
Infective endocarditis (IE) is an infection of the endothelial surface of the heart and heart valves with serious, even fatal, complications and that often requires long-term and expensive treatment. Dental procedures may lead to IE in high-risk patients. The aim of this study was to evaluate and compare the knowledge of general dentists and dental students concerning the prevention of IE in Hamadan, Iran. In this cross-sectional study, the awareness of general dentists and dentistry students concerning the prevention of IE was evaluated during 2010. A questionnaire was prepared and administered to 58 final-year dental students and 96 general dental practitioners in Hamadan. A total of 154 persons completed the questionnaire. The questionnaire consisted of some demographic questions and questions about awareness of IE in three sections. The gathered data were analyzed by using descriptive statistics, Pearson's chi-square test, Mann-Whitney test, and independent t-tests. The gathered data showed that dentistry students answered the questions about awareness of the prevention of IE more correctly than did general dentists. The overall knowledge of endocarditis prophylaxis among students and dentists was about 65% and 56%, respectively. The students' knowledge was better because 94.9% of the students had desired (acceptable) and relatively desired knowledge; this result for dentists, however, was 82.3%. In our study, the overall awareness level of the study population was moderate. Dentist and students believed that patients with prosthetic valves and previous IE were the most common cardiac disease cases that required prophylaxis. The most common prophylactic regimen was in accordance with the guidelines of the American Heart Association and was a single dose of 2 g amoxicillin 1 hour before treatment. The results indicated that gender had no effect on the level of knowledge; however, there was a statistically significant relationship between age and level of knowledge.
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Affiliation(s)
- Fatemeh Ahmadi-Motamayel
- Research Center for Molecular Medicine, Department of Oral Medicine, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
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Kim YJ, Cho SB, Park SW, Hong HJ, Lee DH, Cho EA, Kim H, Choi SK, Rew JS. Body mass index and nonresponse to antiviral treatment in korean patients with genotype 2 and 3 chronic hepatitis C. Chonnam Med J 2012; 48:21-6. [PMID: 22570811 PMCID: PMC3341433 DOI: 10.4068/cmj.2012.48.1.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 02/06/2012] [Indexed: 12/09/2022] Open
Abstract
Pegylated-interferon plus ribavirin is the standard treatment for chronic hepatitis C. Sustained virological response (SVR) rates of up to 80% are reported in genotype 2 and 3 chronic hepatitis C cases. Obesity, a modifiable risk factor, may have a deleterious effect on antiviral treatment. We performed this study to examine the efficacy and safety of pegylated-interferon and ribavirin therapy in Korean patients with genotype 2 and 3 chronic hepatitis C and to investigate the risk factors for nonresponse to antiviral treatment. A total of 121 patients were treated with peginterferon alpha-2a 180 mcg/week plus ribavirin 800 mg/day for 24 weeks. The end-of-treatment virologic response (ETVR), the SVR, the end-of-treatment biochemical response (ETBR), the sustained biochemical response (SBR), and the adverse events were analyzed. The ETVR and SVR were 94.1% and 89.1%, respectively. The ETBR was 80.2% and the SBR was 96%. Multivariate analysis showed that a body mass index of 25 and over was the only independent factor that affected the SVR (odds ratio=10.5, 95% confidence interval: 2.006-54.948, p=0.005). Twenty patients (16.5%) dropped out at the end of treatment, and 7 (5.8%) patients discontinued treatment because of treatment-related adverse events. Our study showed that combination therapy with pegylated-interferon and ribavirin as an initial treatment for genotype 2 and 3 chronic hepatitis C is very effective and safe, and that body mass index is an independent risk factor for nonresponse to antiviral treatment in patients with genotype 2 and 3 chronic hepatitis C.
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Affiliation(s)
- Yeon Joo Kim
- Department of Internal Medicine, Chonnam University Medical School, Gwangju, Korea
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45
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Kim TY. The effect of alanine aminotransferase dynamics on predicting sustained virological response in chronic hepatitis C virus infection. Korean J Hepatol 2012; 18:29-31. [PMID: 22511900 PMCID: PMC3326988 DOI: 10.3350/kjhep.2012.18.1.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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