Direct Acting Antiviral Agents in Korean Patients with Chronic Hepatitis C and Hemophilia Who Are Treatment-Naïve or Treatment-Experienced

Lee, Hyun Woong; Yoo, Kyung Yeon; Won, Joung Won; Kim, Hyung Joon

doi:10.5009/gnl17209

Cited by 13 publications

(15 citation statements)

References 23 publications

(25 reference statements)

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“…As a fact, our lost-to-follow-up population ( n = 8) consisted of a PWH/HCV+ with no other information regarding evolution of HCV infection, patients who were not proposed for IFN therapy ( n = 6), and a PWH treated with IFN and lost to follow-up without any subsequent information. Our data is also compatible with that of other cohorts [29], showing a lower mean age of infection than that of the general population at risk for HCV due to haemophilia treatment with inactivated plasma products from childhood.…”

Section: Discussionsupporting

confidence: 92%

“…With the development and approval of DAA drugs, the treatment of HCV has witnessed a true revolution, with patients achieving higher rates of cure with significant less adverse events and shorter time regimens [29]. Initial studies on DAAs did not include patients with special comorbidities, as real-life studies lacked significant data for patients with inherited haemorrhagic disorders [31].…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection

Guedes

Garrido

Küttner-Magalhães

et al. 2020

GE Port J Gastroenterol

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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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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection

Guedes

Garrido

Küttner-Magalhães

et al. 2020

GE Port J Gastroenterol

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“…DAAs have been proven efficacious both in patients who were deemed contraindicated in the IFN era or those who achieved reduced SVR rates . Surprisingly, data on patients with bleeding disorders and chronic HCV infection are still limited as to date only one ad‐hoc multicentre clinical trial from US, 1 multicentre international clinical trial on patients with several different haematological disorders including a subgroup with haemophilia and von Willebrand disease and 5 small case series from Japan, Korea, New Zealand and China have been reported so far . Although the SVR12 rates in those reports ranged from 92% to 100%, on average no more than 50 patients per study were analysed (only the multicentre trial included 120 cases), making broad assumptions on the safety and efficacy of DAA agents in patients with congenital bleeding disorders impossible.…”

Section: Discussionmentioning

confidence: 99%

High rate of sustained virological response with direct‐acting antivirals in haemophiliacs with HCV infection: A multicenter study

Mancuso

Linari²,

Santagostino

et al. 2020

Liver International

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Background and Aims: Chronic hepatitis C is the main co-morbidity in adult patients with haemophilia (PwH). It causes progressive liver damage leading to end-stage liver disease and/or hepatocellular carcinoma. Eradication of HCV was possible with interferon (IFN)-based regimens in the past and direct-acting antivirals (DAAs) more recently. PwH have been considered "difficult-to-treat" because of several bad predictors of response. The advent of DAAs has provided high rates of sustained virological response (SVR) despite bad prognostic factors. Here, we present the results of antiviral treatment with DAAs in PwH treated in 2 large Italian Hemophilia Treatment Centers. Methods: PwH and chronic hepatitis C sustained by any HCV genotype were eligible for therapy with DAAs, including those with compensated cirrhosis, HIV infection and/or previous failure to IFN-based antiviral therapy. Patients received DAAs for 8-24 weeks according to existing guidelines. SVR was defined as persistent negative serum HCV-RNA at 12 weeks after treatment completion (SVR12). patients aged 21-84 years (median: 50.5) received DAAs. HCV genotype 1 was the most prevalent (158, 79%). Forty patients (20%) were HIV positive, 56 (28%) had cirrhosis and 91 (46%) previously failed interferon-based treatment. Ribavirin was used in 70 (35%). HCV-RNA was undetectable at week 4 in 124/192 (65%) and SVR12 was achieved in 193/195 (99%). No patient had serious side effects related to DAAs.Conclusions: DAAs were safe and highly effective in PwH irrespective of HIV status, stage of liver disease severity and/or previous failure to IFN-based therapy.

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“…46 Many recent studies suggest that individuals with IBD may safely and successfully be treated for HCV with the DAA therapy. 71 In five recent studies investigating the DAA treatment in 254 hemophiliacs and von Willebrand disease patients, of whom 51 were cirrhotic, 243 were cured of hepatitis C. [71][72][73][74][75] Other reports in thalassemic patients documented cure of 401 out of the 420 recruited patients with various genotypes and degrees of fibrosis. [76][77][78][79] The average success HCV cure rate in patients with IBD was 95% in published studies.…”

Section: Inherited Blood Disordersmentioning

confidence: 99%

Hepatitis C Virus Treatment in Children: A Challenge for Hepatitis C Virus Elimination

El-Sayed

Indolfi

2020

Semin Liver Dis

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Hepatitis C is a global public health threat. The introduction of direct-acting antivirals (DAAs) brings the prospect of curing the 71 million people living with the disease, dramatically changing the landscape of hepatitis C. The World Health Organization developed a roadmap for the elimination and cure of hepatitis C by 2030 with a clear goal with measurable targets. However, there is a lack of a well-defined strategy to tackle the hepatitis C virus (HCV) problem in children and adolescents vis-à-vis the adult population. Hepatitis C in children and adolescents can be addressed as part of a national policy for elimination in the whole population, namely macroelimination, or could be fragmented into a microelimination approach targeting the high-risk population groups. Children born to HCV-infected mothers, adolescents who are injecting drugs, migrants, and those suffering from inherited blood diseases are important target populations. After the U.S. Food and Drug Administration approval for the use of DAAs in children aged 3 years and above, evidence from clinical trials and real-world experience was accumulated using brand and generic medicines, with sustained virological response rates exceeding 95%. The evidence created should guide policies on the management of hepatitis C in children and adolescents. There are many challenges in managing HCV in this left-behind marginalized population. The lack of awareness and epidemiological data, consent age, prohibitive prices of medicines, and absence of policies on access to diagnostics, treatment, and linkage to care are among the many barriers to service delivery that should be addressed to achieve the elimination goal by 2030.

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Direct Acting Antiviral Agents in Korean Patients with Chronic Hepatitis C and Hemophilia Who Are Treatment-Naïve or Treatment-Experienced

Cited by 13 publications

References 23 publications

Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection

Long-Term Follow-Up of a Portuguese Single-Centre Cohort of Persons with Haemophilia and Hepatitis C Virus Infection

High rate of sustained virological response with direct‐acting antivirals in haemophiliacs with HCV infection: A multicenter study

Hepatitis C Virus Treatment in Children: A Challenge for Hepatitis C Virus Elimination

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