Simple predictors of nonresponse to direct-acting antivirals in chronic hepatitis C patients
Autor: | Hosam Dabes, Magdy Alserafy, Mohamed Said, Yehia ElShazly, Doa’a A. Saleh, Yasmin Saad, Hend Ibrahim Shousha |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Cirrhosis Sustained Virologic Response Hepacivirus DIRECT ACTING ANTIVIRALS Antiviral Agents Gastroenterology 03 medical and health sciences 0302 clinical medicine Chronic hepatitis Internal medicine medicine Humans Platelet Retrospective Studies Univariate analysis Hepatology business.industry Albumin virus diseases Retrospective cohort study Hepatitis C Chronic medicine.disease digestive system diseases Work-up 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business |
Zdroj: | European Journal of Gastroenterology & Hepatology. 32:1017-1022 |
ISSN: | 0954-691X |
Popis: | OBJECTIVES The introduction of direct acting antivirals (DAAs) has resulted in very high sustained virological response rates (SVR) in patients with chronic hepatitis-C (CHC). There are still a minority who fails to achieve SVR. This study aims to identify simple factors associated with nonresponse to DAAs using routine pretreatment workup. METHODS A retrospective study included 10 655 CHC patients who were candidates for anti-viral therapy. Pretreatment demographics, laboratory results, ultrasonography and FIB-4were obtained. RESULTS At post-treatment week 4, 10 495 patients (98.5%) were responders and 160 (1.5%) were non-responders. About 50.6% of non-responders were males and 61.3% were cirrhotic. Non-responders had significantly higher baseline BMI, liver enzymes, AFP and a significantly lower albumin, platelet count by univariate analysis ((P < 0.001). Sex, previous treatment, BMI, liver cirrhosis, AST, Albumin and platelet counts were the independent predictors of non-response. At post-treatment week 12, HCV-PCR results were available only for 7259 patients and 210 (2.9%) were non-responders. 54.8% of non-responders were cirrhotic and 51.4% were males. Non-responders had significantly higher AST, AFP and INR and a significantly lower albumin level, platelet count by univariate analysis (P < 0.05). Sex, previous treatment, AST, Albumin, WBC and platelet counts were the independent predictors of non-response. SVR-4 among treatment naive patients was 98.6% while among treatment experienced was 96.8%. SVR-12 among treatment naive patients was 97.9% while among treatment experienced was 87.9%.Cirrhotics had SVR-4 rate 97.7% and SVR-12 rate 96.21%. CONCLUSION Routine pre-treatment work up for HCV G4 patients receiving DAAs can help in prediction of non-response. |
Databáze: | OpenAIRE |
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