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Direct-Acting Antivirals in Chronic Hepatitis C Genotype 4 Infection in Community Care Setting
Vijay Gayam1, Mazin Khalid1, Amrendra Kumar Mandal1
1Department of Medicine and Gastroenterology, Interfaith Medical Center, 1545 Atlantic Ave., Brooklyn, NY 11213, USA.
Insights
Direct-acting antivirals (DAAs) show high effectiveness and tolerability in treating chronic Hepatitis C Genotype 4 (HCV GT-4) in community settings. This study found a 94% sustained virologic response rate, demonstrating DAAs as a successful treatment option.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Limited data exists on direct-acting antiviral (DAA) safety, tolerability, and efficacy for chronic Hepatitis C Genotype 4 (HCV GT-4) in community practice.
- This study addresses the need for real-world data on DAA treatment outcomes in this population.
Purpose of the Study:
- To evaluate the treatment response, including safety, tolerability, and efficacy, of direct-acting antivirals (DAAs) in patients with chronic Hepatitis C Genotype 4 (HCV GT-4) in a community setting.
Main Methods:
- Retrospective analysis of 52 HCV GT-4 patients treated with DAAs between January 2014 and October 2017.
- Assessment of pretreatment characteristics, sustained virologic response at 12 weeks (SVR12), and adverse reactions.
Main Results:
- An overall SVR12 rate of 94% was achieved across three DAA regimens (ledipasvir/sofosbuvir, ombitasvir/paritaprevir/ritonavir/dasabuvir, sofosbuvir/Velpatasvir).
- Specific SVR12 rates were 93.8% for Harvoni®, 91.7% for ViekiraPak®, and 100% for Epclusa®.
- Fatigue was the most common adverse effect (27%); compensated cirrhosis did not significantly impact SVR rates.
Conclusions:
- Direct-acting antivirals (DAAs) are effective and well-tolerated for chronic HCV GT-4 infection in real-world community settings.
- A high overall sustained virologic response (SVR) rate of 94% was observed.
- Further large-scale studies are recommended to validate these findings in broader patient groups.
Background:
Limited data exists comparing the safety, tolerability, and efficacy of direct-acting antivirals (DAAs) in patients with chronic hepatitis C genotype 4 (HCV GT-4) in the community practice setting. We aim to evaluate the treatment response of DAAs in these patients.
Methods:
All the HCV GT-4 patients treated with DAAs between January 2014 and October 2017 in a community clinic setting were retrospectively analyzed. Pretreatment baseline patient characteristics, treatment efficacy with sustained virologic response (SVR) at 12 weeks post treatment (SVR12), and adverse reactions were assessed.
Results:
Fifty-two patients of Middle Eastern (primarily Egyptian) descent were included in the study. Thirty-two patients were treated with ledipasvir/sofosbuvir (Harvoni®) ± ribavirin, 12 patients were treated with ombitasvir/paritaprevir/ritonavir/dasabuvir (ViekiraPak®) ± ribavirin, and eight patients were treated with sofosbuvir/Velpatasvir (Epclusa®). Ten patients (19.2%) had compensated cirrhosis. Overall, SVR at 12 weeks was achieved in 94% in patients who received one of the three DAA regimens (93.8% in Harvoni® group, 91.7 % in ViekiraPak® group and 100% in Epclusa® group). Prior treatment status and type of regimen used in the presence of compensated cirrhosis had no statistical significance on overall SVR achievement (P value = 0.442 and P value = 0.091, respectively). The most common adverse effect was fatigue (27%).
Conclusions:
In the real-world setting, DAAs are effective and well tolerated in patients with chronic HCV GT-4 infection with a high overall SVR rate of 94%. Large-scale studies are needed to further assess this SVR in these groups.
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