Role of Ribavirin in the Era of Direct–Acting Antiviral Therapies of Chronic Hepatitis C

Alhaddad, Omkolsoum; Wahb, Ahmed; Sabry, Alyaa; Khalil, Fatma Omar; Elsabaawy, Dalia; Elshazly, Helmy; Shebl, Nashwa; Rady, Mohamed; Elsabaawy, Maha

doi:10.1080/14787210.2020.1758557

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…With SVR in place, hepatic inflammation should decrease, which could account for this phenomenon. Consistent with our results, several investigations found that hepatic transaminase levels dropped significantly after SVR in response to DAAs (16) . Also El Kassas et al (17) who examined the effect of DAA therapy on ALT levels in 1160 patients with chronic hepatitis C Liver enzymes were observed to be significantly reduced in Egyptian individuals treated with interferon-free regimens compared to those treated with interferon-containing regimens.…”

Section: Discussionsupporting

confidence: 93%

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Impact of Direct Acting Antivirals Therapy on Novel Fibrosis Index for Assessment of Hepatic Fibrosis in Comparison with AST to Platelet Ratio and Fibrosis-4 (FIB-4) Indexes in Egyptian Patients with Chronic Hepatitis C Infection in Correlation with Fibroscan

Allam

El-Karmouty

Kaisar

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Scarring or progressive fibrosis and cirrhosis develop over time as a result of chronic viral infection, which induces inflammation and tissue healing via deposition of extracellular matrix. There has been an increase in the sustained virological response (SVR) and the rate of eradication of HCV because of the effectiveness of directacting antiviral drugs (DAAs). Reduced hepatic fibrosis is associated with increased SVR rates. There are a variety of non-invasive fibrosis imaging, scoring, and marker methods: transient elastography, aminotransferase platelet ratio index (APRI), as well as fibrosis-4 (FIB-4) score. Objective: The purpose of this research was comparing the novel fibrosis index to APRI, (FIB-4) score and fibroscan in predicting the degree of hepatic fibrosis in Egyptian chronic HCV patients who were managed by DAAs. Patients and methods: 100 Egyptians with chronic HCV infection participated in a our 3-month long prospective Cohort research using the IFN-free DAA combination of Sofosbuvir and Daclatasvir ± Ribavirin. Results: There was significant regression of fibrosis with DAAs treatment in all patients achieving SVR by fibroscan, APRI and fib4. Novel fibrosis index is reliable and good tool in estimation of liver fibrosis in correlation to fibroscan, with the cutoff value in prediction of hepatic fibrosis stage 4 was >3.1 and has sensitivity of 81.5% while the specificity was 74.1%. Conclusion Novel fibrosis index has been found to be good reliable marker for assessment of liver fibrosis with high accuracy of predicting f4 fibrosis stage. There was significant marked reduction of fibrosis degree by fibroscan, APRI and FIB4 after DAAs treatment.

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Section: Discussionsupporting

confidence: 93%

“…It had mean values of 13.19 and 12.57 gm/dl before and after treatment respectively done by Shousha et al (15) . Additionally, Alhaddad et al (16) also reported a significant change in hemoglobin level after DAA therapy. It decreased from 12.28 gm/dl down to 10.09 gm/dl after treatment.…”

Section: Discussionmentioning

confidence: 95%

Impact of Direct Acting Antivirals Therapy on Novel Fibrosis Index for Assessment of Hepatic Fibrosis in Comparison with AST to Platelet Ratio and Fibrosis-4 (FIB-4) Indexes in Egyptian Patients with Chronic Hepatitis C Infection in Correlation with Fibroscan

Allam

El-Karmouty

Kaisar

et al. 2023

The Egyptian Journal of Hospital Medicine

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“…In ultimate end, this study confirmed that RBV may still have a role in the therapy of HCV patients for its added value to achieve SVR in combination with a SOF monotherapy. We could also speculate that, as suggested by others, in this cohort of subjects with compensated cirrhosis RBV contributed to the shortening of therapy, with acceptable side effects in most cases and without loss of efficacy or real treatment disruption urgencies 57 . However, larger multicenter trails are mandated for better configuration of final decisions on which exact doses are required for such patients on an individual basis, beyond the previously reported fixed start doses based merely on body weight.…”

Section: Discussionmentioning

confidence: 51%

“…We could also speculate that, as suggested by others, in this cohort of subjects with compensated cirrhosis RBV contributed to the shortening of therapy, with acceptable side effects in most cases and without loss of efficacy or real treatment disruption urgencies. 57 However, larger multicenter trails are mandated for better configuration of final decisions on which exact doses are required for such patients on an individual basis, beyond the previously reported fixed start doses based merely on body weight. In this respect, RBV steady-state plasma levels would seem promising for both predicting SVR and preventing significant anemia, and may be used as a tool in addition to simple RBV toxicity monitoring for a more rational average drug dose adjusting in the case of patients with difficult-to-cure characteristics such as impaired renal function and/or cirrhosis.…”

Section: Lence (≥10%) Also For What Concerns This Ethnicity Mainly In Westernmentioning

confidence: 99%

Sofosbuvir‐based therapies in genotype 2 hepatitis C virus cirrhosis: A real‐life experience with focus on ribavirin dose

Smirne

D’Avolio

Bellan

et al. 2021

Pharmacology Res & Perspec

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“…It had mean values of 13.19 and 12.57 gm/dl before and after treatment respectively. Additionally, Alhaddad (15) and his coworkers also reported a significant change in hemoglobin level after DAAs therapy. It decreased from 12.28 gm/dl down to 10.09 gm/dl after treatment.…”

Section: Discussionmentioning

confidence: 93%

Study of the effect of direct acting antivirals (DAAs) on fibrosis in chronic hepatitis C patients using transient elastography

Mohammed¹,

Attia²,

Ebeid³

et al. 2021

World J. Adv. Res. Rev.

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Back ground: As DAA agents are leading to enormous cure rates, so identifying and monitoring patients who remain at a high complication risk after achieving SVR continue to be a critical issue. Numerous validated methods for noninvasive measurement of liver fibrosis can be used in the management of HCV infection. Methods study: A total of 50 Egyptian chronic HCV patients eligible for treatment with DAAs were enrolled in this prospective study. All subjects selected from Virology Unit of Tropical Medicine Department, Faculty of Medicine, Beni-Suef University received DAAs (SOV DCV) the endpoint was a sustained virologic response at 12 (SVR12) weeks post-treatment. All participants were evaluated non-invasively by Liver Stiffness Measurement (LSM) by Fibro Scan before DAAs treatment, and 6 months post-treatment. Results: SVR achieved by DAAs therapy was 96 % and was associated with significant improvement (p ˂0.05) of non-invasive fibrosis markers (FIB-4, APRI score, and LSM by Fibro Scan) from baseline compared to 6 months post-treatment. Using fibro scan regression of fibrosis in 30/45 patients (66%). Liver inflammation and synthetic functions also improved on follow up 12w and 6m post treatment. Conclusion: Regression of Liver inflammation and fibrosis in chronic hepatitis C patients post treatment with SOF DCV.

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Role of Ribavirin in the Era of Direct–Acting Antiviral Therapies of Chronic Hepatitis C

Cited by 5 publications

References 14 publications

Impact of Direct Acting Antivirals Therapy on Novel Fibrosis Index for Assessment of Hepatic Fibrosis in Comparison with AST to Platelet Ratio and Fibrosis-4 (FIB-4) Indexes in Egyptian Patients with Chronic Hepatitis C Infection in Correlation with Fibroscan

Impact of Direct Acting Antivirals Therapy on Novel Fibrosis Index for Assessment of Hepatic Fibrosis in Comparison with AST to Platelet Ratio and Fibrosis-4 (FIB-4) Indexes in Egyptian Patients with Chronic Hepatitis C Infection in Correlation with Fibroscan

Sofosbuvir‐based therapies in genotype 2 hepatitis C virus cirrhosis: A real‐life experience with focus on ribavirin dose

Study of the effect of direct acting antivirals (DAAs) on fibrosis in chronic hepatitis C patients using transient elastography

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