Efficacy and tolerability of an IFN-free regimen with DCV/ASV for elderly patients infected with HCV genotype 1B

Toyoda, Hidenori; Kumada, Takashi; Tada, Toshifumi; Shimada, Noritomo; Takaguchi, Koichi; Senoh, Tomonori; Tsuji, Kiichiro; Tachi, Yoshihiko; Hiraoka, Atsushi; Ishikawa, Toru; Shima, Toshihide; Okanoue, Takeshi

doi:10.1016/j.jhep.2016.11.012

Cited by 41 publications

(34 citation statements)

References 16 publications

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“…The main etiology of HCC in Japanese patients has been reported to be HCV infection [33,35]. Development of direct-acting antiviral drug therapy for HCV [36,37] has led to an extremely high rate of HCV elimination, allowing for maintenance of hepatic function without progression of hepatic fibrosis after sustained virologic response (SVR). However, treatment of HCC after SVR with direct-acting antiviral drug therapy remains controversial, because the incidence of HCC after SVR in a group of interferon-free patients was reported to be >2-fold higher than that in an interferon-based therapy group (7.29 vs. 3.09% and 6.23 vs. 3.01%) [38].…”

Section: Discussionmentioning

confidence: 99%

Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function

et al. 2017

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Background/Aim: Recently, albumin-bilirubin (ALBI) scoring/grading, consisting of only albumin and total bilirubin, has been proposed. We examined the efficacy of this grading system for determining hepatic function in patients with hepatocellular carcinoma (HCC). Methods/Materials: The prognoses of 46,681 HCC patients based on results obtained from a nationwide survey conducted in Japan from 2001 to 2007 were evaluated using (1) Japan Integrated Staging (JIS), consisting of Child-Pugh classification and TNM staging (TNM), (2) modified JIS (m-JIS), consisting of liver damage grading and TNM, and (3) ALBI-TNM (ALBI-T), consisting of ALBI grading and TNM, and the results were compared. A subanalysis was also performed to define a cutoff value for ALBI scores for a more detailed stratification of hepatic function. Results: ALBI-T, JIS, and m-JIS each showed good capacity for the stratification of prognoses. Although the Akaike information criterion for ALBI-T was nearly equal to that for JIS and m-JIS, the Kaplan-Meier curves and median survival times obtained with ALBI-T were always superior to the corresponding scores. When the indocyanine green retention test (<30%) was used as an additional cutoff value for ALBI score (-2.270, area under the curve 0.828) to divide ALBI grade into 4 levels (modified ALBI [mALBI] grade), mALBI grade was able to stratify the prognosis of patients at any TNM stage in order of grade. Modified ALBI-T (mALBI-T), using mALBI grading and TNM, produced a more detailed stratification for prognosis. Conclusion: The predictive value for prognosis of ALBI-T was found to be equal to that of JIS and m-JIS. In addition, mALBI grading and mALBI-T, as proposed in the present study, might provide a more detailed assessment of the hepatic function and prognosis of HCC patients.

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Section: Discussionmentioning

confidence: 99%

Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function

et al. 2017

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“…Sustained virologic response (SVR) rates of ≥90% could be achieved even in clinical practice . Treatments with DAAs enable us to achieve high SVR rates for patients with more advanced liver disease and of older ages who were difficult to treat in the era of interferon (IFN)‐based treatment …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Treatments with DAAs enable us to achieve high SVR rates for patients with more advanced liver disease and of older ages who were difficult to treat in the era of interferon (IFN)-based treatment. [4][5][6] Among those treated with IFN-based treatments, the cumulative rate of hepatocellular carcinoma (HCC) occurrence is higher in non-SVR patients than in SVR patients. 7,8 Furthermore, among those treated with IFN-free treatment, the cumulative rate of HCC occurrence is higher in non-SVR patients than in SVR patients.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma occurrence does not differ between interferon‐based and interferon‐free treatment with liver histological assessment

Tahata

Sakamori

Urabe

et al. 2020

Hepatology Research

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Aim Several studies have recently reported that hepatocellular carcinoma (HCC) occurrence does not differ between hepatitis C virus patients receiving interferon (IFN)‐based and IFN‐free treatments considering the patients’ backgrounds. However, liver fibrosis was not directly considered in these studies. Methods In total, 3972 patients without a history of HCC who started IFN‐based or IFN‐free treatment between August 2002 and April 2017 at 30 Japanese hospitals and achieved a sustained virologic response were included. Propensity score matching considering liver histology was performed. Results The median age and percentage of patients with advanced liver fibrosis (F3/4) were 58 years and 11.4% in the IFN‐based group, and 68 years and 18.9% in the IFN‐free group, respectively. The HCC occurrence rates at 1 year and 2 years were 0.4% and 1.1% in the IFN‐based group, and 1.6% and 4.1% in the IFN‐free group, respectively, and HCC occurrence in the IFN‐free group was significantly higher than that in the IFN‐based group (P < 0.001). The characteristics of the HCC occurrence patterns did not differ between the two groups. After propensity score matching, among 764 patients, the HCC occurrence rates at 1 year and 2 years were 0.5% and 1.9% in the IFN‐based group and 1.1% and 3.0% in the IFN‐free group, respectively, and no significant difference was observed between the two groups (P = 0.489). Conclusions HCC occurrence in sustained virologic response patients does not differ between IFN‐based and IFN‐free treatment considering liver fibrosis stage. The degree of its progress at diagnosis does not differ between the two groups.

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“…They have resulted in higher rates of sustained virological response (SVR), shorter and simpler regimens, and minimal treatment‐related side effects. Many patients with chronic HCV infection, including asymptomatic carriers as well as patients with chronic hepatitis and decompensated cirrhosis, have recently received DAA therapy and achieved SVR in Japan . However, the long‐term prognosis of patients with chronic HCV infection, especially asymptomatic carriers, remains incompletely characterized.…”

Section: Introductionmentioning

confidence: 99%

Natural history of liver‐related disease in patients with chronic hepatitis C virus infection: An analysis using a Markov chain model

Tada

Toyoda

Yasuda

et al. 2019

Journal of Medical Virology

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Background Long‐term prognosis of patients with chronic hepatitis C infection (HCV) remains incompletely characterized. We investigated the long‐term prognosis of liver disease in patients with chronic HCV infection who have not received antiviral therapy. Methods A total of 2304 patients with chronic HCV who were not received interferon‐based therapy were included. Results In the assessment of 1‐year disease state of liver transition probabilities, progression to chronic hepatitis occurred in 12% to 14% of patients across all age groups in male asymptomatic carriers. In male patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (7.6%) and ≥70 age groups (9.6%). In addition, in male patients with cirrhosis, HCC development occurred in approximately 5% of patients over the age of 40. In female asymptomatic carriers, progression to chronic hepatitis was observed in 6% to 14% of patients across all age groups. In female patients with chronic hepatitis, progression to cirrhosis was observed mostly in the 60 to 69 (8.7%) and ≥70 (7.4%) age groups. In addition, in female patients with cirrhosis, HCC development occurred in 0.9% to 3.3% of patients over the age of 50. Under assumptions of either chronic hepatitis or asymptomatic carrier state at age 40 as the starting condition for simulation over the following 40 years, the probability of HCC gradually increased with age and was higher in male patients. Conclusions There is a risk of cirrhosis or HCC development in HCV patients with not only chronic hepatitis but the asymptomatic carrier state as well.

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Efficacy and tolerability of an IFN-free regimen with DCV/ASV for elderly patients infected with HCV genotype 1B

Cited by 41 publications

References 16 publications

Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function

Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function

Hepatocellular carcinoma occurrence does not differ between interferon‐based and interferon‐free treatment with liver histological assessment

Natural history of liver‐related disease in patients with chronic hepatitis C virus infection: An analysis using a Markov chain model

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