Effectiveness of chronic hepatitis C treatment with direct-acting antivirals in the Public Health System in Brazil

Holzmann, Iandra; Tovo, Cristiane Valle; Minmé, Roseline; Leal, Mônica P.; Kliemann, Michele P.; Ubirajara, Camila; Aquino, Amanda A.; Araújo, Bruna; Almeida, Paulo Roberto Lerias de

doi:10.1016/j.bjid.2018.06.004

Cited by 20 publications

(23 citation statements)

References 28 publications

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“…Higher SVR rate was observed among women. This finding is comparable to other studies [6,14,15] where SVR rate varied by gender with males having lower HCV cure rate. The factors account for this difference are not well understood.…”

Section: Discussionsupporting

confidence: 90%

High sustained viral response among HCV genotype 3 patients with advanced liver fibrosis: real-world data of HCV elimination program in Georgia

et al. 2020

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Objective: In 2015, Georgia launched HCV elimination program. Initially, patients with advanced liver disease were treated with sofosbuvir-based regimen-the only DAA available for all genotypes. Purpose of the study was assessing real-world data of treatment outcome among patients with HCV GEN3 and advanced liver fibrosis with sofosbuvirbased regimens. Results: Totally 1525 genotype 3 patients were eligible for analysis; most (72.6%) were aged > 45 years, majority were males (95.1%), and all (100%) had advanced liver disease (F3 or F4 by METAVIR score based on elastography). Of those who received sofosbuvir/ribavirin (SOF/RBV) for 24 weeks, 79.3% achieved SVR, while 96.5% who received sofosbuvir/ pegylated interferon/ribavirin (SOF/PEG/RBV) for 12 weeks achieved SVR (p < 0.01). Among patients with liver cirrhosis (defined as F4) overall cure rate was 85.7% as opposed to 96.4% for those with F3. Females were more likely to be cured (98.7% vs 89.7%; OR = 8.54). Patients aged 31-45 years had higher likelihood of achieving SVR compared to patients aged 46-60 years (95.7% vs 87.4%; OR = 0.32,). Independent predictors of SVR were treatment with SOF/PEG/ RBV (aOR = 6.72) and lower fibrosis stage (F3) (aOR = 4.18). Real-world experience among HCV GEN3 patients with advanced liver fibrosis and treated by sofosbuvir regimen w/o PEGIFN, demonstrated overall high SVR rate.

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Section: Discussionsupporting

confidence: 90%

High sustained viral response among HCV genotype 3 patients with advanced liver fibrosis: real-world data of HCV elimination program in Georgia

et al. 2020

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“…All these small studies showed that this pangenotypic combination is safe and effective when used in clinical practice, even in patients with advanced liver disease …”

Section: Discussionmentioning

confidence: 99%

“…This study included 296 patients, 59% (n = 175) received treatment with SOF/DCV achieving SVR in 84% of patients infected with genotype 3, and 95% in genotype 1 infected patients ( P < 0.05). Within the Brazilian Public Health System, 286/1002 (28.5%) treated patients received SOF/DCV, achieving SVR in 93.0% of cases, and 435/2000 (43.4%) received SOF/DCV/RBV achieving SVR in 95.4% (415) of cases . Another Brazilian study included 219 treated patients with DAAs with 51 subjects receiving SOF/DCV ± RBV and achieving SVR in 95% of cases…”

Section: Discussionmentioning

confidence: 99%

B.A.R.C.O.S. (Brazilian Argentine Hepatitis C Collaborative Observational Study): Effectiveness and clinical outcomes of HCV treatment with daclatasvir and sofosbuvir with or without ribavirin

Ridruejo

Cheinquer

Marciano

et al. 2019

Journal of Viral Hepatitis

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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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“…Borges Neto FC, et al Efetividade do tratamento com drogas antivirais de ação direta em pacientes com hepatite C A população estudada também mostrou características clínicas e demográficas semelhantes às das populações analisadas em outros estudos, como os estudos nacionais citados anteriormente 13,14,15,16,17,18 , mostrando uma população predominantemente masculina, idosa, urbana, com elevado percentual de cirróticos e pacientes experimentados com tratamentos anteriores.…”

Section: /9unclassified

Efetividade do tratamento com drogas antivirais de ação direta em pacientes com hepatite C atendidos em um centro de referência no estado do Pará, Brasil, de 2017 a 2019

Borges

Souza

Novaes

et al. 2020

Revista Pan-Amazônica de Saúde

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Avaliar a efetividade e a tolerabilidade do tratamento da hepatite C com antivirais de ação direta em pacientes portadores de hepatite C crônica, atendidos no Ambulatório de Hepatologia da Fundação Santa Casa de Misericórdia do Pará, em Belém, estado do Pará, Brasil. MATERIAIS E MÉTODOS: Estudo transversal, realizado com 305 pacientes em tratamento com sofosbuvir (SOF), daclatasvir (DAC) ou simeprevir (SMV) de maio de 2017 a março de 2019. Foram analisados os prontuários de 250 pacientes que concluíram o tratamento nesse período, dos quais foram avaliados dados demográficos e clínicos. RESULTADOS: Observou-se predomínio do gênero masculino (50,40%), idade média de 61,21 anos e procedência de Belém (69,20). A maioria (54,00%) era portador de cirrose, e 40,80% relatou tratamento anterior. O genótipo 1 foi encontrado em 73,60%, e o genótipo 3, em 23,20% dos casos. O esquema de tratamento mais utilizado foi SOF, DAC e ribavirina (RBV) por 12 semanas. A taxa de resposta virológica sustentada (RVS) geral encontrada foi de 97,2%. Os não respondedores eram quatro do genótipo 3 e três do genótipo 1, sendo utilizados três esquemas com SOF+DAC+RBV por 12 semanas; dois esquemas com SOF+DAC por 12 semanas; um esquema com SOF+DAC por 24 semanas; e um esquema com SOF+SMV por 12 semanas. CONCLUSÃO: Os resultados deste estudo mostraram uma população predominantemente urbana, masculina, a maioria de cirróticos, com predomínio do genótipo 1. Ressalta-se a boa tolerância e a elevada efetividade dos novos antivirais de ação direta, com uma taxa global de RVS de 97,2%.

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Effectiveness of chronic hepatitis C treatment with direct-acting antivirals in the Public Health System in Brazil

Abstract: The treatment of chronic hepatitis C virus infection for genotypes 1, 2 or 3 with the therapeutic regimens established by the Brazilian guidelines showed high rates of SVR, even in cirrhotic patients.

Cited by 20 publications

References 28 publications

High sustained viral response among HCV genotype 3 patients with advanced liver fibrosis: real-world data of HCV elimination program in Georgia

High sustained viral response among HCV genotype 3 patients with advanced liver fibrosis: real-world data of HCV elimination program in Georgia

B.A.R.C.O.S. (Brazilian Argentine Hepatitis C Collaborative Observational Study): Effectiveness and clinical outcomes of HCV treatment with daclatasvir and sofosbuvir with or without ribavirin

Efetividade do tratamento com drogas antivirais de ação direta em pacientes com hepatite C atendidos em um centro de referência no estado do Pará, Brasil, de 2017 a 2019

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