Assessment of the treatment of chronic hepatitis C in the state of Mato Grosso, central Brazil

Abstract

In Brazil, the treatment of hepatitis C virus (HCV) infection is funded by the national public health system (SUS). To evaluate treatment results in the state of Mato Grosso, central Brazil, we have consulted the files of the office of the State Department of Health responsible for supplying such medications. We obtained information on 232 treatments of 201 patients who underwent treatment in or prior to 2008. The study was conducted by reviewing medical records, making telephone calls and interviewing the assistant physicians. Thirty-nine patients (19.4%) had cirrhosis and HCV genotype 1 predominated (64.3%). Excluding patients with comorbidities or treatment without ribavirin we analysed 175 treatments (sustained virologic response occurred in 32.6% of cases). Twenty-six of these 175 were retreatments and the sustained virological response (SVR) rate among them was 30.8%; the SVR rate was 32.9% among those receiving treatment for the first time. The SVR rate of genotype 1 patients was 27.8%, whereas it was 37.5% in non-1 genotype patients. The adjusted multivariate analysis showed association of SVR with the absence of cirrhosis [odds ratio (OR): 7.7; confidence interval (CI) 95%: 2.5, 33.3], the use of pegylated interferon (OR: 5.8; CI 95%: 1.5, 21.4), non-1 genotype (OR: 5.3; CI 95%: 1.7, 16.7) and uninterrupted treatment (OR: 9.0; CI 95%: 3.3, 45.4). The SVR rates were similar to those found in other Brazilian studies about HCV, but lower than those found in national and international clinical trials. These data suggest that the treatments of chronic hepatitis C that are made available by SUS does not, under normal conditions, work as well as the original controlled studies indicated

Hepatitis C Worldwide and in Brazil: Silent Epidemic—Data on Disease including Incidence, Transmission, Prevention, and Treatment

“…Regarding the treatment of chronic hepatitis C, Azevedo and colleagues [63] demonstrated SVR rates of approximately 30% in patients who received either conventional interferon or pegylated interferon in combination with ribavirin. The same SVR rate was shown in another study with patients who received only the conventional interferon and ribavirin [64].…”

Observational descriptive study of cutaneous manifestations in patients from Mato Grosso with viral chronic hepatitis

“…In addition, these figures certainly represent underreporting, since only the number of patients with chronic hepatitis C treated between 2002 and 2008 by Sistema Único de Saúde (SUS) was 268. 8 Another fact that shows the poor accuracy of this information is the notification of 14 cases of hepatitis E, a disease that does not have tests available in public healthcare system and that needs molecular biology tests to be confirmed. In fact, only one human case has been confirmed so far in the country.…”

Assessment of the treatment of chronic hepatitis C virus infection: a case series from a hospital in the Brazilian Amazon region

“…In Brazil some studies evaluating the efficacy of the treatment for chronic hepatitis C have been published, such as the study conducted by Azevedo et al, who first demonstrated a SVR rate of 32.6% in the state of Mato Grosso, lower than rates found in the South and Southeast regions. 4 I would like to share the preliminary results of a larger study of the treatment of the hepatitis C virus infection in which we are investigating the role of interleukin 28B and ancestrality as predictive factors of SVR. The treatment of hepatitis C virus (HCV) infection is provided free-of-charge by the national public health system (SUS) in Belém do Pará, northern Brazil, where conventional interferon or pegylated interferon combined with ribavirin was used in the study period.…”