Effectiveness of hepatitis C antiviral treatment and feasibility of hepatitis C elimination goal.

Autor:	Burgui C; Instituto de Salud Pública de Navarra, Pamplona, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain., San Miguel R; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Farmacia Hospitalaria, Hospital Universitario de Navarra, Pamplona, Spain., Goñi-Esarte S; Servicio de Digestivo, Hospital Universitario de Navarra, Pamplona, Spain., Juanbeltz R; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Farmacia Hospitalaria, Hospital Universitario de Navarra, Pamplona, Spain., Úriz-Otano JI; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Digestivo, Hospital Universitario de Navarra, Pamplona, Spain., Reparaz J; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Medicina Interna, Hospital Universitario de Navarra, Pamplona, Spain., Sarobe M; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Farmacia Hospitalaria, Hospital Universitario de Navarra, Pamplona, Spain., Zozaya JM; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.; Servicio de Digestivo, Hospital Universitario de Navarra, Pamplona, Spain., Castilla J; Instituto de Salud Pública de Navarra, Pamplona, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Jazyk:	angličtina
Zdroj:	Postgraduate medicine [Postgrad Med] 2023 May; Vol. 135 (4), pp. 352-360. Date of Electronic Publication: 2022 Nov 04.
DOI:	10.1080/00325481.2022.2141499
Abstrakt:	Objectives: Second-generation direct-acting antivirals (DAAs) have shown high efficacy in the treatment of chronic hepatitis C virus (HCV) infections in clinical trials. This study aimed to estimate the effectiveness in real-life conditions and their capacity to eliminate HCV infection in the general population. Methods: In this observational cohort study, patients with active HCV infection who commenced DAA treatment between 2015 and 2020 in Navarre, Spain, were studied. Sustained virological response (SVR), defined as an undetectable viral load 12 weeks after the end of treatment, was evaluated until the end of 2021. Results: Of a total 1366 HCV-infected patients that commenced treatment, 19.3% (n = 263) were HIV-coinfected. After the first DAA treatment, SVR was achieved in 96.6% (n = 1320/1366) of patients and in 97.7% (95% confidence interval [CI] 96.6%-98.3%) of those who completed treatment (per-protocol analysis; n = 1320/1351). SVR was achieved in 97.9% (n = 1066/1089) and 96.9% (n = 254/262) of mono-infected and HIV-coinfected patients, respectively. Thirty-one patients had virological failure due to non-response (n = 19), poor compliance (n = 9), and with adverse events (n = 3). Of 27 patients that received a second treatment, 24 attained SVR (one after a third treatment), two died, and one that did not achieve SVR declined a third treatment. Three patients were re-infected, re-treated, and achieved SVR. At the end of the study, 1344 patients (98.4%, 95% CI 97.6%-98.9%) had achieved SVR, and only 1.8% needed more than one course of treatment. All patients who completed the treatment and were followed-up achieved SVR. Conclusion: With DAAs, SVR was achieved in all patients with active HCV infection who completed follow-up, and a second course of treatment was only necessary in a small proportion of patients. Adherence to treatment is essential for HCV infection elimination.
Databáze:	MEDLINE
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