Direct-acting Antiviral Regimens for Patients with Chronic Infection of Hepatitis C Virus Genotype 3 in China

Wang, Xiaozhong; Wei, Lai

doi:10.14218/jcth.2020.00097

Cited by 6 publications

(7 citation statements)

References 196 publications

(326 reference statements)

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“…The lack of corrective function of HCV NS5B RNA-dependent RNA polymerase leads to the susceptibility to mutation during HCV replication, and resistance-associated substitutions may occur during viral mutation, whereas approximately 94%–96% of GT3b-infected patients carry the A30K + L31M double NS5A resistance-associated substitutions, so GT3b infection is difficult to cure. [ 25 , 26 ] Therefore, even after achieving SVR in patients with GT3b, they are still at a risk of relapsing and requires intensive surveillance.…”

Section: Discussionmentioning

confidence: 99%

Five-year follow-up of sustained virological response with hepatitis C infection after direct-acting antiviral therapy: A single-center retrospective study

Li,

Zhang

et al. 2024

Medicine

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In recent years, direct-acting antivirals (DAAs) have dramatically improved the sustained virological response (SVR) rates in chronic hepatitis C (CHC) patients with their favorable safety and efficacy. However, there is a lack of data on the long-term prognosis of DAA therapy for CHC patients after achieving SVR in the real world. The aim of this study was to evaluate the long-term clinical prognosis of patients with chronic hepatitis C treated by DAA after achieving SVR. This study was a single-center, retrospective, observational study that included 243 CHC patients who reached SVR after DAA treatment in the Third Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2021, with a median follow-up period (FUP) of 24 months, to assess the long-term prognosis and clinical outcomes of CHC patients who reached SVR by DAA treatment. A total of 243 patients were enrolled in this study, 151 patients were male, the mean age of this study was 46.7 ± 12.3 years old, and 23.0% (n = 56) patients were cirrhosis in the baseline. At the end of follow-up, 9 patients (3.7%) progressed to hepatocellular carcinoma (HCC), and patients with cirrhosis at baseline (n = 5) had a significantly higher risk of HCC compared with noncirrhotic patients (n = 4; OR = 4.485, 95% CI: 1.162–17.318, P = .029); 2.9% patients (n = 7) relapsed at the median FUP of 12 months, and patients with genotype 3b had a significantly higher risk of relapsing than those without genotype 3b (OR = 18.48, P = .002, 95% CI: 2.866–119.169). ALT, AST, and ALB all showed improvement at the end of treatment compared with the baseline, remaining at normal levels during FUP meanwhile. The DAA-induced SVR was durable, with conspicuous improvement in clinical outcomes. Nevertheless, patients, especially patients with cirrhosis, still exist the risk of appearance of HCC after reaching SVR. Therefore, regular surveillance and monitoring is necessary even after patients reached SVR.

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Section: Discussionmentioning

confidence: 99%

Five-year follow-up of sustained virological response with hepatitis C infection after direct-acting antiviral therapy: A single-center retrospective study

Li,

Zhang

et al. 2024

Medicine

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“…In GT3 infection, there was a 13% difference in the proportion of cirrhotic participants between males and females (males 34% vs. females 21%), whereas the difference in the proportion of cirrhotic participants was only 5% in the GT1 population (males 24% vs. females 19%). In other published trials, the presence of cirrhosis affected SVR rates in those with HCV GT3 infection 33–35 ; unfortunately, many published trials do not consistently report outcomes by sex.…”

Section: Discussionmentioning

confidence: 99%

Sex‐related difference analyses of efficacy and safety in clinical trials of direct‐acting antivirals to treat chronic HCV genotype 1 and 3 infections

Zhou,

Qi,

Bersoff‐Matcha

et al. 2023

Journal of Viral Hepatitis

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This study aims to identify clinically meaningful sex differences in efficacy and selected safety adverse events for the treatment of chronic hepatitis C virus infection (HCV) or HIV/HCV co‐infection in those receiving combination direct‐acting antiviral (DAA) regimens. Our assessment was based on adult trial participants treated at the approved DAA dosage and treatment duration from 40 phase 3 clinical trials submitted to the FDA. Female enrollment ranged from 11% to 54% (overall mean 38%). Females with HCV genotype (GT) 1 or 3 infection had statistically significant higher unadjusted or covariant‐adjusted odds of achieving sustained virologic response at post‐treatment Week 12 (SVR12) compared with males. Odds ratios favouring females were observed among Whites and those ≥40 years of age with HCV GT1 or 3 infections, and among those ≥50 years of age, non‐cirrhotic and those with HCV GT3 infection who were treatment‐experienced. These differences were not clinically relevant due to the high SVR12 rate achieved by females and males, overall or in subgroups. No differences were observed in SVR12 rates between HCV GT1 mono‐infected and HCV GT1/ HIV‐1 co‐infected participants. Numerically, more females reported headache, fatigue and nausea compared to males, but the differences were small and predominately Grade 1 or 2 severity. Discontinuation rates for any reason or due to an adverse event were low and similar between the sexes. Our study demonstrated females successfully complete DAA regimens and achieve high SVR12 rates despite numerically higher adverse events for certain commonly reported events.

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“…Its cure rates with the first-generation DAAs, telaprevir and boceprevir, lagged behind those of other major genotypes in the past [ 15 ]. Nonetheless, the 12-week sofosbuvir-velpatasvir protocol adopted for this patient has been shown to have SVR of up to 95% in Western countries and 91% in China, respectively, for HCV genotype 3a [ 16 ], making it an excellent choice for treating HCV infection with this peculiar subtype.…”

Section: Discussionmentioning

confidence: 99%

Conspicuous Response to Direct-Acting Antivirals in Chronic Hepatitis C-related Immune Thrombocytopenia: A Case Report

Tsai¹,

Jhou²,

Fan³

2022

Cureus

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A 39-year-old man with a history of intravenous drug use was diagnosed to have a sudden onset of immune thrombocytopenia (ITP) in the background of a chronic hepatitis C infection with genotype 3a. Two courses of high-dose pulse dexamethasone therapy (40 mg daily for consecutive four days) failed to raise the platelet counts, but a combination direct-acting antiviral (DAA) regimen of sofosbuvir and velpatasvir, which had been proved to be effective for all hepatitis C virus (HCV) genotypes, successfully restored the platelets number to normal ranges after hepatitis C virus ribonucleic acid (RNA) was totally eliminated. Molecular mimicry of hepatitis C virus envelope proteins with platelet surface antigens is proposed to be the underlying cause of immune thrombocytopenia. An adequate direct-acting antiviral regimen is considered to be the most reliable therapy for hepatitis C-related immune thrombocytopenia.

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Direct-acting Antiviral Regimens for Patients with Chronic Infection of Hepatitis C Virus Genotype 3 in China

Abstract: Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection

Cited by 6 publications

References 196 publications

Five-year follow-up of sustained virological response with hepatitis C infection after direct-acting antiviral therapy: A single-center retrospective study

Five-year follow-up of sustained virological response with hepatitis C infection after direct-acting antiviral therapy: A single-center retrospective study

Sex‐related difference analyses of efficacy and safety in clinical trials of direct‐acting antivirals to treat chronic HCV genotype 1 and 3 infections

Conspicuous Response to Direct-Acting Antivirals in Chronic Hepatitis C-related Immune Thrombocytopenia: A Case Report

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