Genotype 3 Infection: The Last Stand of Hepatitis C Virus

Chan, Austin; Patel, Keyur; Naggie, Susanna

doi:10.1007/s40265-016-0685-x

Cited by 61 publications

(64 citation statements)

References 89 publications

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“…Within the failure cohort HCV3 genotype was the predominant thus consolidating the evidence supporting the inverse association between HCV3 and SVR above 95%‐99%. These real‐life findings further underscore the need for effective therapy for this group of patients who experience higher rates of steatosis, faster progression to cirrhosis and higher rates of HCC …”

Section: Discussionmentioning

confidence: 99%

Real‐life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study

Persico

Aglitti

Milella

et al. 2019

Liver International

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Background and aims:It is paramount to identify predictors of treatment failure with direct antiviral agents in 'field-practice' patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field-practice scenario are scant. The multicentre MISTRAL study enrolled 1177 patients, including PWID, to assess real-life efficacy and safety of GLE/PIB and to identify the predictive factors for this treatment. Methods:This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12.Results: A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3.METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID.Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non-substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ 2 < 0.001). A total of 40/118 (33.9%) of substance users were HCV3 compared to 83/1056 (7.9%) non-substance users.Only 6 patients (0.5%) reported a serious adverse event. Conclusions:The MISTRAL study provides evidence of GLE/PIB efficacy in a fieldpractice scenario in a highly epidemic HCV area in southern Italy; it unveiled significant differences in genotype distribution among the most underserved and difficult-to-treat patient subgroups including PWID. K E Y W O R D S cirrhosis, direct-acting antiviral, efficacy, HCV genotype, substance abuse Keypoints • The MISTRAL study shows that glecaprevir/pibrentasvir is effective for the treatment of hepatitis C virus in a field-practice scenario in a highly epidemic area in southern Italy. Handling editor: Alessio Aghemo S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Persico M, Aglitti A, Milella M, et al. Real-life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study. Liver Int.

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Section: Discussionmentioning

confidence: 99%

Real‐life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study

Persico

Aglitti

Milella

et al. 2019

Liver International

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“…The prevalence of drug resistance among donors might be even higher as 15% of donors in the THINKER trial had NS5A mutations . Similarly, ~8% of GT3 patients might have NS5A: Y93H mutations . Of concern is Patient 9 who failed to respond to two courses of treatment (ELB/GZR for 12 weeks and G/P for 16 weeks).…”

Section: Discussionmentioning

confidence: 99%

“…9 Similarly, ~8% of GT3 patients might have NS5A: Y93H mutations. 25 Of concern is Patient 9 who failed to respond to two courses of treatment (ELB/GZR for 12 weeks and G/P for 16 weeks). His drug adherence pattern well, and plans to travel now that he is off dialysis.…”

Section: Discussionmentioning

confidence: 99%

Ultra-short duration direct acting antiviral prophylaxis to prevent virus transmission from hepatitis C viremic donors to hepatitis C negative kidney transplant recipients

Gupta

Yakubu

Bhati

et al. 2020

American Journal of Transplantation

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We conducted an adaptive design single‐center pilot trial between October 2017 and November 2018 to determine the safety and efficacy of ultra‐short‐term perioperative pangenotypic direct acting antiviral (DAA) prophylaxis for deceased hepatitis C virus (HCV)‐nucleic acid test (NAT) positive donors to HCV negative kidney recipients (D+/R−). In Group 1, 10 patients received one dose of SOF/VEL (sofusbuvir/velpatasvir) pretransplant and one dose on posttransplant Day 1. In Group 2A (N = 15) and the posttrial validation (Group 2B; N = 25) phase, patients received two additional SOF/VEL doses (total 4) on Days 2 and 3 posttransplant. Development of posttransplant HCV transmission triggered 12‐week DAA therapy. For available donor samples (N = 27), median donor viral load was 1.37E + 06 IU/mL (genotype [GT]1a: 70%; GT2: 7%; GT3: 23%). Overall viral transmission rate was 12% (6/50; Group 1:30% [3/10]; Group 2A:13% [2/15]; Group 2B:4% [1/25]). For the 6 viremic patients, 5 (83%) achieved sustained virologic response (3 with first‐line DAA therapy; and two after retreatment with second‐line DAA). At a median follow‐up of 8 months posttransplant, overall patient and allograft survivals were 98%, respectively. The 4‐day strategy reduced viral transmission to 7.5% (3/40; 95% confidence interval [CI]: 1.8%‐20.5%) and could result in avoidance of prolonged posttransplant DAA therapy for most D+/R − transplants.

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“…The literature indicates that the average prevalence of LS in patients with hepatitis C is 55% and may vary according to the different viral genotypes [1]. In addition, the presence of genotype 3 is associated with the presence and development of LS in such patients [3]. Regarding the laboratory variables that assess liver damage, significant differences were found only for gamma-glutamyltranspeptidase (GGT) and AP.…”

Section: Discussionmentioning

confidence: 99%

Physical activity as a protective factor against development of liver steatosis in patients infected with hepatitis C

Silva

Fernandes

Lima

et al. 2018

Biomedical Human Kinetics

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SummaryStudy aim: Was to verify whether the regular practice of physical activity promotes some protective factor against the development of LS in patients infected with hepatitis C virus (HCV). Materials and method: Clinical data were obtained through medical records available at the Pernambuco Liver Institute. Physical activity levels were obtained through the International Physical Activity Questionnaire (IPAQ) short form to classify the patients according to the guidelines of the American College of Sports Medicine (ACSM). Results: The sample consisted of patients of both genders, over 18 years of age, who had positive anti-HCV, HCV-RNA and confirmatory tests for presence or absence of liver steatosis. 126 patients were included in the study. Patients with liver steatosis (G1) were more frequently male (57%) compared to patients without liver steatosis (G2) (p = 0.02). Physical activity analysis showed significant differences for GGT (p = 0.04), HDL (p = 0.04), AF (p = 0.02), viral genotype 3 (p = 0.04) and waist-to-hip ratio (p = 0.01) in anthropometric data. Correlation analysis showed a significant difference for GGT (r = -0.23; p = 0.01) and total bilirubin (BT) (r = -0.22; p = 0.01). Conclusions: Regular practice of physical activity generates a protective factor against the development of LS in patients infected by the hepatitis C virus and it is associated with the maintenance of variables related to hepatic and biochemical damage in patients infected with HCV.

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Genotype 3 Infection: The Last Stand of Hepatitis C Virus

Cited by 61 publications

References 89 publications

Real‐life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study

Real‐life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study

Ultra-short duration direct acting antiviral prophylaxis to prevent virus transmission from hepatitis C viremic donors to hepatitis C negative kidney transplant recipients

Physical activity as a protective factor against development of liver steatosis in patients infected with hepatitis C

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