Effectiveness of direct-acting agents for hepatitis C and liver stiffness changing after sustained virological response
Flavia F Fernandes
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorJuliana Piedade
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorLivia Guimaraes
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorEstevao P Nunes
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorUrsula Chaves
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorRafaela V Goldenzon
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorSandra W Cardoso
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorJoana Duarte
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorBeatriz Grinsztejn
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorValdilea G Veloso
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorGustavo Pereira
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
School of Medicine, Estácio de Sá University, Rio de Janeiro, Brazil
Search for more papers by this authorCorresponding Author
Hugo Perazzo
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Correspondence
Dr Hugo Perazzo, Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil, 4365, CEP 21040-360 Rio de Janeiro, Brazil.
Email: [email protected]; [email protected]
Search for more papers by this authorFlavia F Fernandes
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorJuliana Piedade
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorLivia Guimaraes
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorEstevao P Nunes
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorUrsula Chaves
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorRafaela V Goldenzon
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorSandra W Cardoso
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorJoana Duarte
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
Search for more papers by this authorBeatriz Grinsztejn
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorValdilea G Veloso
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Search for more papers by this authorGustavo Pereira
Gastroenterology and Hepatology Department, Bonsucesso Federal Hospital, Rio de Janeiro, Brazil
School of Medicine, Estácio de Sá University, Rio de Janeiro, Brazil
Search for more papers by this authorCorresponding Author
Hugo Perazzo
Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
Correspondence
Dr Hugo Perazzo, Laboratory of Clinical Research on STD/AIDS, Evandro Chagas National Institute of Infectious Disease (INI)—Oswaldo Cruz Foundation (FIOCRUZ), Av. Brasil, 4365, CEP 21040-360 Rio de Janeiro, Brazil.
Email: [email protected]; [email protected]
Search for more papers by this authorAbstract
Background and Aim
Few studies have evaluated sustained virological response (SVR) rates by direct-acting agents (DAAs) and liver stiffness measurement (LSM) changing post-SVR in limited-resource settings. We aimed to describe the effectiveness of DAAs for hepatitis C virus treatment and to assess the changing of LSM post-SVR.
Methods
This retrospective study analyzed data of consecutive hepatitis C virus-infected patients treated by DAAs from 2015 to 2017 in two tertiary centers in Brazil. SVR rates were reported by intention-to-treat and per-protocol analyses. LSM by transient elastography performed before treatment and post-SVR was compared, and logistic regression models were performed.
Results
Six hundred seventy-one patients (63% female, 62 years [55–68], 89% genotype 1, 8% HIV co-infected, and 64% with cirrhosis) were included. Most patients were treated by sofosbuvir/daclatasvir ± ribavirin (74%) and sofosbuvir/simeprevir ± ribavirin (21%). SVR rates (95% confidence interval [CI]) were 94.6% (92.7–96.1) and 97.8% (96.4–98.7) for intention-to-treat and per-protocol analyses, respectively. The leading adverse event was anemia (9.6% [95% CI 7.6–12.1]). Pretreatment and post-SVR12 LSM were available in 400 patients. LSM had significantly decreased after SVR (13.6 kPa [interquartile range, 10.0–21.6] vs 10.2 kPa [7.0–17.6], P < 0.001). A total of 167 patients (42%) decreased at least 30% of LSM post-SVR. The absence of type 2 diabetes (odds ratio = 1.52 [95% CI 1.05–2.21], P = 0.028) and presence of platelet count ≥ 150 × 109/mm3 (odds ratio = 1.75 [1.23–2.50], P = 0.002) were independently associated with a significant LSM regression (≥ 30%) post-SVR.
Conclusion
DAAs were highly effective and safe, and LSM significantly decreased after SVR in a real-life cohort in Brazil. The absence of type 2 diabetes and presence of high platelet count were independently associated with LSM decrease post-SVR.
Supporting Information
| Filename | Description |
|---|---|
| jgh14707-sup-0001.docxWord 2007 document , 25.9 KB |
Table S1. Sustained virological response (SVR) rates by sofosbuvir/daclatasvir (SOF/DCV) and sofosbuvir/simeprevir (SOF/SIM) ± ribavirin (RBV) as per-protocol (n=649) analysis. Table S2. Factors associated with no response to direct-acting agents treatment in HCV-infected patients as the per-protocol analysis (n=649). Table S3. Demographic and clinical characteristic of patients according to inclusion in the analysis of LSM changing after sustained virological response (SVR). |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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