Sofosbuvir Based Regimens in the Treatment of Chronic Hepatitis C with Compensated Liver Cirrhosis in Community Care Setting

Gayam, Vijay; Mandal, Amrendra; Khalid, Mazin; Mukhtar, Osama; Gill, Arshpal; Garlapati, Pavani; Khalid, Mowyad; Mansour, Mohammed

doi:10.1155/2018/4136253

Cited by 9 publications

(15 citation statements)

References 28 publications

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“…This result highlights the potency of DAAs in HCV elimination, a finding that is following the previously published results [15]. Despite the proven potency of DAAs in patients with liver cirrhosis [16], the SVR12 among patients with cirrhosis in the current study was relatively low (71.4%) although all the cirrhotic patients were Child–Pugh class A; this could be explained by the low number of cases ( n = 14).…”

Section: Discussionsupporting

confidence: 86%

Direct antiviral drugs in the treatment of hepatitis C-infected rheumatoid arthritis Egyptian cohort: safety and clinical impact

Lashen¹,

Metawea²,

Shaaban

2020

European Journal of Gastroenterology &Amp; Hepatology

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Background and aim Data about the safety and efficacy of direct-acting antivirals (DAAs) in the treatment of hepatitis C virus (HCV) patients with concomitant rheumatoid arthritis (RA) are scarce. We assessed the impact and safety of DAAs treatment of hepatitis C on rheumatoid arthritis disease activity. Patients and methods Prospectively, we enrolled 65 patients with RA and HCV. A clinico-laboratory evaluation was done at baseline, including liver assessment and RA disease activity score-28 (DAS28). At 12 weeks of post-DAAs treatment, sustained virologic response (SVR12) and DAS28 were reevaluated. Results The SVR12 was achieved in 59 (90.8%) patients. RA control was achieved in 47 (79.9%) patients. The post SVR12 DAS28 score was significantly lower than the baseline (3.32 ± 0.93 vs. 4.37 ± 0.90; P < 0.001). There was a significant decline in the mean values of serum anticyclic citrullinated peptide, rheumatoid factor, erythrocyte sedimentation rate and C-reactive protein after achieving an SVR12 (30.47 ± 12.37 vs. 57.61 ± 15.91 U/ml; 29.78 ± 19.58 vs. 55.14 ± 16.89 IU/ml; 17.13 ± 10.84 vs. 29.68 ± 14.32 mm/h and 5.76 ± 1.57 vs. 11.44 ± 4.13 mg/l, respectively; P < 0.05). RA activity and antirheumatic drugs were stepped-down [12 (20.3%) and 35 (59.3%) patients showed good and moderate RA response, respectively]. The baseline viral load, absence of cirrhosis and SVR12 were the only predictors of disease control (P < 0.05). No drug-related adverse events or drug-related discontinuation. Conclusions Unlike interferon, HCV elimination by DAAs significantly improves RA activity and treatment outcome with high safety and efficacy.

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Section: Discussionsupporting

confidence: 86%

Direct antiviral drugs in the treatment of hepatitis C-infected rheumatoid arthritis Egyptian cohort: safety and clinical impact

Lashen¹,

Metawea²,

Shaaban

2020

European Journal of Gastroenterology &Amp; Hepatology

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“…The treatment of HCV has shifted toward more tolerable, safer oral regimens with the use of direct-acting antiviral agents (DAAs). These regimens have truly revolutionized the efficiency of HCV treatment by achieving a sustained virologic response (SVR), shortening the duration of treatment, and improving patient outcomes without the burden of neuropsychiatric adverse effects [11,[16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Gayam

Jegede

Tiongson

et al. 2019

Dig Dis

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Background: The highest burden of hepatitis C virus (HCV) infection is seen in patients with psychiatric disorders who have been excluded from traditional treatments with Interferon due to treatment-emergent neuropsychiatric adverse effects. The goal of this study is to determine the tolerability, treatment retention, and efficacy of direct-acting antivirals with psychiatric disorders and comorbid substance use disorders in real-life settings. Methods: This is a retrospective cohort observational study of HCV patients treated with direct-acting antivirals between January 2016 and December 2018. Patients were stratified and sub-stratified based on their psychiatric diagnosis and substance use. The primary assessment was the sustained virologic response at 12 weeks post-treatment (SVR12). Results: Among the 291 patients analyzed, patients with psychiatric diagnosis and non-psychiatric patients made up 51.2% (n = 149) and 48.8% (n = 142) respectively. Majority of the patients included in the study were African-Americans (68.7%, n = 200). Overall, 95.3% (142/149) and 94.4% (134/142) of psychiatric and nonpsychiatric patients, respectively, achieved SVR12 and treatment response was similar between the groups (p = 0.72). Among psychiatric patients, only the prior treatment status was identified as a predictor of treatment response (OR 0.153, 95% CI 0.03-0.79; p = 0.05). No statistical difference was observed among the patients with SVR12 based on their primary psychiatric diagnoses or by comorbid substance abuse. Conclusion: The results of our study show that directacting antiviral treatments are well tolerated in psychiatric patients, and an overwhelming majority of patients achieved SVR12. Our study highlights the need to integrate HCV screening with treatment linkage in psychiatry and primary care practice.

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“…Regarding the clinical examination, we found that 95% of our study group showed no signs of hepatic decompensation, while 2% of them had ascites and lower limb oedema, 1% had ascites, 1% had jaundice, and 1% had lower limb oedema only. This could be explained by the fact that one patient developed HCC post-DAAs with further decompensation [15].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Fibrosis Regression Using FIB-5 Score in HCV and HBV Positive Patients after Treatment and Virus Suppression Respectively.

Hussein,

Gomaa,

Hassan

et al. 2024

Fayoum University Medical Journal

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Introduction: Background: Chronic liver disease (CLD) is a major cause of morbidity and mortality worldwide. Assessment of liver fibrosis (LF) via the utilization of noninvasive tests (NITs) has been emerging nowadays. These NITs, FIB-4 and FIB-5, have adequate predictive positive value (PPV) for the diagnosis of nil or minimal fibrosis up to advanced fibrosis. Aim of study:To detect fibrosis regression after HCV treatment and HBV suppression using the FIB-5 score and evaluate the accuracy of the FIB-5 score as a validated NIT of fibrosis compared to FIB-4. Subjects and Methods:This is a prospective study on 100 patients with chronic hepatitis, 50 HCV patients who received direct-acting anti-viral drugs (DAAs) about 5 years ago and achieved sustained virological response (SVR), and 50 HBV patients with undetected viremia who are still on treatment according to the national program for treatment of HCV and Egyptian guidelines for HBV treatment, respectively. Results:The sensitivity and specificity tests for FIB-5 level post-treatment in the diagnosis of fibrosis regression in HCV patients were 88.2% and 63.6%, respectively, at a cutoff value of -14.695. The sensitivity and specificity tests for FIB-5 level post-treatment in the diagnosis of fibrosis regression in HBV patients were 57.1% and 94.4%, respectively, at a cutoff value of -8.68. Conclusion:FIB-5 is both a specific and sensitive test to assess fibrosis regression in chronic hepatitis patients after and during treatment.

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Sofosbuvir Based Regimens in the Treatment of Chronic Hepatitis C with Compensated Liver Cirrhosis in Community Care Setting

Cited by 9 publications

References 28 publications

Direct antiviral drugs in the treatment of hepatitis C-infected rheumatoid arthritis Egyptian cohort: safety and clinical impact

Direct antiviral drugs in the treatment of hepatitis C-infected rheumatoid arthritis Egyptian cohort: safety and clinical impact

Outcomes of Direct-Acting Antiviral Treatment of Psychiatric Patients with Comorbid Hepatitis C Virus Infection

Evaluation of Fibrosis Regression Using FIB-5 Score in HCV and HBV Positive Patients after Treatment and Virus Suppression Respectively.

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