This study provides evidence of the relevance of liver diseases within the framework of the Brazilian Unified Health System, and shows that the burden of these diseases is not only significant but progressive, at least in terms of hospital admissions and mortality rate.

Real-world data evaluating the effectiveness of direct-acting antivirals (DAAs) in hepatitis C virus (HCV) treatment have been reported from different regions. Our aim was to evaluate the effectiveness and clinical outcomes of daclatasvir (DCV) and sofosbuvir (SOF) ± ribavirin (RBV) in a prospective multicentre cohort study including patients from Argentina and Brazil who received DCV/SOF ± RBV for 12 or 24 weeks from 2015 to 2018. Multivariable logistic regression models were carried out to identify factors associated with failure to achieve sustained virologic response (SVR) as a primary end point, and to death, decompensation, hepatocellular carcinoma (HCC) or liver transplantation (LT) as a composite secondary end point. From a total of 1517 patients treated with DCV/SOF, 906 completed 12 weeks post-treatment evaluation and were included in the analysis. Overall SVR12 rate was 96.1% (95% CI: 94.6%-97.2%), and 95% (95% CI: 92.8%-96.6%) in patients with cirrhosis. LT recipients and presence of cirrhosis were independently associated with failure to achieve SVR. During post-SVR12 follow-up, cumulative incidence of the secondary end point was 2.4% (95% CI: 1.5%-3.6%); two patients died from nonliver-related causes and two from HCC, five underwent LT, 12 developed HCC and 17 patients developed hepatic decompensation. Independent variables associated with these composite | 1201 RIDRUEJO Et al.

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where 94 HCV patients were followed-up by 12 weeks during the antiviral therapy. All patients underwent liver biopsy and through laboratory data, the values for noninvasive methods, APRI, FIB-4 and GPR, were calculated to assess the accuracy of the tests in relation to liver biopsy, also considering the viral genotypes. RESULTS: The concordance of APRI in relation to liver biopsy for advanced fibrosis was AUROC = 0.67 (CI 95% 0.55-0.79). The GPR method represent an AUROC = 0.59 (CI 95% 0.46-0.73) for advanced fibrosis, while FIB-4 represent an AUROC = 0.69 (CI 95% 0.58-0.80) for advanced fibrosis. No significant difference was found when compared the three tests used (p = 0.306). Moreover, when evaluated the tests in relation to the viral genotypes, we found only statistical difference for GPR (p = 0.006), with better accuracy for genotype 2-3. CONCLUSION: We found association between viral genotypes and advanced fibrosis in the relationship of GPR; however, the results showed no good accuracy for all index evaluated in our population.

Introduction: Adverse effects of peginterferon/ribavirin therapy and sociodemographic factors are known to modify hematological parameters. The present study was aimed to evaluate the impact of sociodemographic characteristics on laboratorial blood profile during treatment of Chronic Hepatitis C (CHC). Method: This is a Cohort of 136 patients with CHC in treatment with peginterferon/ribavirin. Sociodemographic and laboratorial profile were collected in the baseline, 4th and 12th weeks of treatment. Results: The mean age of patients was 53±11.7 years, 78 (57.4%) were men, 119 (87.5%) were Caucasian. Hemoglobin levels decreased along the treatment from baseline (14.3 ±1.7 g/dL) to 4th (12.0 ±1.8 g/dL) and 12th (11.5 ±1.6 g/dL; p=0.001). Leukocytes values also decreased from baseline to 4th and 12th weeks of treatment (6805.6 ±6574.3/mm3; 3827.6 ±1650.3/mm3 and 3541 ±2056/mm3, respectively; p=0.001), as well as platelets values (175168.06 ±60846.7mm3, 138612.06 ±59356.6/mm3, and 127279.1 ±56333.6/mm3, respectively; p=0.001). Men had greater values of hemoglobin along treatment (p=0.001), while older (p=0.012) and non-Caucasian patients (p=0.008) have lower values. Platelets levels were reduced in older (p=0.007) and men patients (p=0.001) along treatment. Conclusion: social factors as sex, age, and ethnicity, showed greater impact on hematological variables during CHC treatment, revealing an important point to be considered since may influence the management of treatment.