Evaluation of Direct Acting Antivirals Efficiency in Turkish Patients with Chronic Hepatitis C Under Strict Rules

Abstract

In chronic hepatitis C treatment, direct acting antivirals have a strong effect and are well tolerated since 2014, yet it is unclear whether resource-constrained countries have the same achievement. This study aimed at evaluating direct acting antivirals used to treat Turkish chronic hepatitis C patients between the years of 2016 to 2017. Within the one-year period, 101 out of 105 patients reached a sustained virological response rate. The type of direct acting antivirals and treatment length were chosen according to the Health Implementation Guideline of Turkey. The analyses of effectiveness according to therapeutic regimes showed the following sustained virological response rate: Ledipasvir/sofosbuvir and +/-; ribavirin (97%), ombitasvir/paritepravir/dasabuvir and +/-; ribavirin (100%) and sofosbuvir + ribavirin (100%). One patient had virological relapse on the 12th week by the end of the therapy. In this patient, cross-resistance mutation Y93H was specified for the NS5A region. On the other hand, amino acid changes, S282G and C316S, were determined in the NS5B region. The adverse effects were 22% in all patients. Most of them were mild or moderate. The researchers concluded that the results of the highly efficient and well-tolerated therapy with direct acting antivirals could be examples in resource-constrained countries. In addition, resistant variants should be detected after unsuccessful treatment in the management of new therapy options.

In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey

“… 9 But it may be difficult to access DAAs in low- and middle-income countries. 10 , 11 The ease of use for a new treatment is a driving force for the WHO initiate that aims to develop a strategy to eliminate HCV as a major public health threat by 2030. Specific targets include an 80% reduction in new infections, a 65% reduction in HCV-related deaths, and 80% of the HCV-infected population in treatment.…”

Incidence and predictors of direct-acting antiviral treatment failure in Turkish patients with chronic hepatitis C genotype 1b infection

“…There have been only a few studies on outcomes of IFN-free DAA therapy in Turkish HCV genotype 1b patients. [10][11][12] Consequently, very little is known about the incidence of treatment failure in this group. The aim of the present study was to assess this and possible predictors of virologic failure in a real-life Turkish genotype 1b cohort.…”