Summary In randomized controlled trials of patients with chronic HCV infection, elbasvir/grazoprevir (EBR/GZR) demonstrated high cure rates and a good safety profile. This study assessed the effectiveness and safety of EBR/GZR, with and without ribavirin, in a real‐world HCV patient cohort. HEPA‐C is a collaborative, monitored national registry of HCV patients directed by the Spanish Association for the Study of the Liver and the Networked Biomedical Research Centre for Hepatic and Digestive Diseases. Patients entered into HEPA‐C between December 2016 and May 2017, and treated with EBR/GZR with at least end‐of‐treatment response data, were included. Demographic, clinical and virologic data were analysed, and adverse events (AEs) recorded. A total of 804 patients were included in the study. The majority were male (57.9%), with a mean age of 60 (range, 19‐92) years. Genotype (GT) distribution was GT 1, 86.8% (1a, 14.3%; 1b, 72.5%); GT 4, 13.2% and 176 patients (21.9%) were cirrhotic. Overall, among 588 patients with available data, 570 (96.9%) achieved sustained virologic response at 12 weeks post‐treatment (SVR12). SVR12 rates by genotype were GT 1a, 97.7%; GT 1b, 98.6%; and GT 4, 98.1%. No significant differences in SVR12 according to fibrosis stage were observed. Eighty patients experienced an AE, resulting in treatment discontinuation in three. In this large cohort of patients with chronic HCV managed in a real‐world setting in Spain, EBR/GZR achieved high rates of SVR12, comparable to those observed in randomized controlled trials, with a similarly good safety profile.

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Fístula esófago pleural en esófago de Barrett Palabras clave: Esófago de Barrett. Fístula esófago-pleural. Perforación esofágica.

BackgroundAcanthamoeba keratitis (AK) is a serious corneal infection that may even lead to loss of sight. Infection prevalence has increased in recent years as the use of contact lenses (CL) has also increased.PurposeTo analyse if there is a difference in duration and efficacy in treatment with chlorhexidine eye drops 0.02% (CED) in AK alone or associated with Pseudomonas spp. To evaluate the prevalence of AK and use of CL as a risk factor.Material and methodsRetrospective descriptive study in a second-level hospital. Total population of this study was 2 70 000 inhabitants over a period of 3 years (2014 to 2016). Data collected: number of patients treated with CED, demographic data, microbiological results (cultures and PCR for Acanthamoeba spp), days of targeted treatment, need for ocular surgery and use of CL. The treatment was: CED with eye drops of 0.1% propamidine isethionate. Farmatools®patient software was used for data collection and patients’ clinic history.ResultsPatients were treated with CED: 36 (55.5% females). Average age: 35 years (18–90). Microbiological culture results: Acanthamoeba spp eight (22.2%), Acanthamoeba spp together with Pseudomonas spp eight (22.2%), Aspergillus spp 4four (11%), Pseudomonas spp together with Serratia spp four (11%) and pathogens were not isolated 12 (33%). In cultures in which Acanthamoeba spp was isolated, PCR was positive in 12 patients (75%). The average duration of treatment with CED targeted to AK was 201 days (48–268). No one AK without Pseudomonas spp required surgical intervention. All AK together with Pseudomonas spp required surgical intervention. All patients with AK were carriers of CL. The prevalence of AK was one case per 50 000 people/year.ConclusionTreatment with CED was effective in all patients with AK without Pseudomonas spp, but it was not effective in any patient with AK with Pseudomonas spp. The period of treatment with CED in AK was long, for the efficacy it was fundamental to the adherence. This study shows a low prevalence according to the criteria of the World Health Organisation. The use of CL was a risk factor in the appearance of AK. The AK should be one of the first possibilities to consider when a user of CL suffers an atypical keratitis.Reference and/or Acknowledgements1. Ophthalmology. S0161–6420(16):32529–5. doi:10. 1016/j. ophtha. 2017. 05. 012No conflict of interest