Treatment of <scp>HCV</scp> infection in Poland at the beginning of the interferon‐free era—the EpiTer‐2 study

Flisiak, Robert; Zarębska-Michaluk, Dorota; Janczewska, Ewa; Staniaszek, A.; Gietka, Andrzej; Mazur, Włodzimierz; Tudrujek, Magdalena; Tomasiewicz, Krzysztof; Belica-Wdowik, Teresa; Baka-Ćwierz, Barbara; Dybowska, Dorota; Halota, Waldemar; Lorenc, Beata; Sitko, Marek; Garlicki, Aleksander; Berak, Hanna; Horban, Andrzéj; Orłowska, Iwona; Simon, Krzysztof; Socha, Łukasz; Wawrzynowicz‐Syczewska, Marta; Jaroszewicz, Jerzy; Deroń, Zbigniew; Czauż-Andrzejuk, Agnieszka; Citko, Jolanta; Krygier, Rafał; Piekarska, Anna; Laurans, Łukasz; Dobracki, Witold; Białkowska, Jolanta; Tronina, Olga; Pawłowska, Małgorzata

doi:10.1111/jvh.12861

Cited by 24 publications

(26 citation statements)

References 21 publications

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“…They were selected from the EpiTer-2, an investigator-initiated study, supported by the Polish Association of Epidemiologists and Infectiologists, which included 22 Polish centres involved in diagnosis and treatment of HCV-infected patients. As presented in the previous publications from the EpiTer-2 study data of consecutive patients who started antiviral therapy after 1 July, 2015, and completed before December 2017 were collected retrospectively with a web-based questionnaire [6–8]. Patients were treated in the therapeutic programme reimbursed by the National Health Fund and consented for treatment and medical procedures according to the standard of care and their data were entered retrospectively into the EpiTer-2 database.…”

Section: Methodsmentioning

confidence: 99%

Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy

Zarębska-Michaluk

Buczyńska

Simon

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

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Background and Aim. The development of interferon- (IFN-) free regimens substantially improved efficacy of treatment for HCV, but despite excellent effectiveness the failures still occur. The aim of our study was to evaluate the efficacy of retreatment with genotype specific direct acting antivirals- (DAA-) based regimens in nonresponders to previous IFN-free therapy. Materials and Methods. Analysed population consisted of 31 nonresponders to IFN-free regimen, which received second IFN-free rescue therapy, selected from 6228 patients included in a national database EpiTer-2. Results. Age and gender distribution were similar, whereas proportion of genotype 1b was slightly higher and genotype 4 lower in the whole population compared to studied one. Patients included in the study demonstrated much more advanced fibrosis. Primary therapy was discontinued in 12 patients, which were recognized as failures due to nonvirologic reason, whereas virologic reason of therapeutic failure was recognized in 19 patients which completed therapy. Overall sustained virologic response (SVR) rate was 81% and 86% in intent-to-treat (ITT) and modified ITT analysis, respectively (74% and 78% in virologic failures, 92% and 100% in nonvirologic failures). Resistance-associated substitutions (RAS) testing was carried out in 8 patients from the group of completed primary therapy and three of them had potential risk for failure of rescue therapy due to NS5A association, while two of them achieved SVR. Conclusions. We demonstrated moderate effectiveness of genotype specific rescue therapy in failures due to virologic reason and high in those who discontinued primary therapy. Therefore rescue therapy with genotype specific regimens should be considered always if more potent regimens are not available.

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Section: Methodsmentioning

confidence: 99%

Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy

Zarębska-Michaluk

Buczyńska

Simon

et al. 2019

Canadian Journal of Gastroenterology and Hepatology

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“…Access to DAA-based therapy in Poland started in 2015 and from the beginning it was available for all patients irrespective of fibrosis [24,25]. Waiting lists for treatment were cleared and currently the major problem is the lack of political will to support a national screening programme.…”

Section: Discussionmentioning

confidence: 99%

How close are we to hepatitis C virus elimination in Central Europe?

Flisiak¹,

Fraňková²,

Grgurević³

et al. 2020

ceh

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Aim of the study: To collect and analyse data obtained from HCV opinion leaders/experts from central European countries, on factors which can affect the WHO target of HCV elimination by 2030. Material and methods: Data were collected from opinion leaders/experts involved in management of HCV infections in Central European countries which participated in 9 th Conference of the Central European Hepatologic Collaboration (Warsaw, 10-11 October 2019). A dedicated questionnaire collected current information related to HCV elimination in Bulgaria, Croatia, the Czech Republic, Hungary, Latvia, Lithuania, Poland and Slovakia. Results: The HCV prevalence rate in particular countries varied from 0.2% to 1.7%. In most central European countries all the HCV infected population is eligible for reimbursement of treatment. However, in some countries there are still some limitations related to the stage of the disease and people who inject drugs. All countries have access to at least one pangenotypic regimen. The most common barrier to HCV elimination in all countries is insufficient political will to establish priority for HCV. None of the reporting countries has established a national screening programme. Conclusions: Access to therapy for HCV is similar and the majority of patients in Central Europe can be treated according to the current guidelines. Unfortunately there are still some limitations and a lack of political will to implement national screening programmes. According to collected data HCV elimination will not be possible in the region by 2030.

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“…Numbers of HIV/HCV-coinfected patients were estimated to be higher in China with the overall prevalence being 41.8% (17). It is probable that the number of HIV/HCV co-infections will decrease in Central and Eastern European countries due to the wide availability of antiviral drugs (18).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics and access to end-stage liver disease care for HIV-positive patients with HCV and

Skrzat‐Klapaczyńska

Matłosz²,

Oțelea

et al. 2019

Przegl Epidemiol

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OBJECTIVES. There is currently an urgent need to harmonize hepatitis standards of care for HIV-positive patients across Europe. The HIV epidemic in Central and Eastern Europe has often been driven by injecting drug use, therefore a higher rate of co-infection with HCV and HBV is expected in this region. We have investigated the epidemiological prevalence and treatment availability for end-stage liver disease in HIV/HCV/HBV coinfections in countries represented in the ECEE Network Group. METHODS. The Euroguidelines in Central and Eastern Europe (ECEE) Network Group was initiated in February 2016 to compare standards of care regarding HIV infection in the region. Information about HIV/HCV/HBV co-infections and the availability for end-stage liver disease treatment for HIV-positive patients were collected through on-line surveys. The respondents were ECEE members from 16 countries of the region. The information on co-infection prevalence was sourced from WHO, national HIV programmes, articles published in international journals, single clinic reports, and personal information in ten of the participating countries (62.5%). RESULTS. The HIV/HCV co-infection rate was from 3% to 99%. The range of reported of HIV/HBV coinfection percentages was 2.3% to 40%. HIV/HCV/HBV co-infection ranged from 0% to 9%. Regarding treatment for end-stage liver disease, liver transplantation was an available option for HIV-positive patients in only three countries (19%). CONCLUSION. Our findings revealed only a limited number of treatment options for the end-stage liver disease in HIV-positive patients for the vast majority of Central and Eastern European countries. There are gaps in epidemiological surveillance in this region. It appears there are many differences in the number of co-infected patients among Central and Eastern European and neighboring countries, but there is no unification of information sources.

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Treatment of HCV infection in Poland at the beginning of the interferon‐free era—the EpiTer‐2 study

Cited by 24 publications

References 21 publications

Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy

Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy

How close are we to hepatitis C virus elimination in Central Europe?

Epidemiological characteristics and access to end-stage liver disease care for HIV-positive patients with HCV and

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