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Direct-Acting Antiviral Treatment in Albanian Patients With Chronic Hepatitis C and Advanced Liver Fibrosis
Liri Cuko1, Sonila Bele2, Adriana Babameto1
1Department of Gastro-Hepatology, University Hospital Center "Mother Teresa", Tirana, ALB.
Insights
Direct-acting antiviral therapy is highly effective for chronic hepatitis C patients in Albania, achieving over 93% sustained virologic response even in those with advanced liver fibrosis. Expanding treatment access is crucial for eradicating hepatitis C by 2030.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Direct-acting antivirals (DAAs) offer highly effective treatment for chronic hepatitis C (CHC).
- DAA treatment in Albania is currently restricted to patients with advanced liver fibrosis (F3-F4) and co-infections.
- CHC affects diverse genotypes, necessitating broad-spectrum treatment approaches.
Purpose of the Study:
- To evaluate the efficacy of DAAs in Albanian patients with CHC genotypes 1-5.
- To assess treatment outcomes in patients with predominantly advanced liver fibrosis.
- To determine the sustained virologic response (SVR) rate in this cohort.
Main Methods:
- Retrospective study conducted at University Hospital Center "Mother Teresa", Tirana (2014-2019).
- Included 207 treatment-naïve and treatment-experienced patients with CHC genotypes 1-5.
- Assessed liver fibrosis using elastography; primary endpoint was SVR-12 (undetectable HCV RNA 12 weeks post-treatment).
Main Results:
- The study included 207 patients (56% male, mean age 48.9 years) with genotypes 1-5.
- Genotype 1 was most prevalent (73%), followed by genotypes 2 (11.5%) and 4 (6.7%).
- Overall SVR-12 rate exceeded 93%, including patients with advanced fibrosis (F3-F4, 66%) and cirrhosis.
Conclusions:
- DAA treatment demonstrates high efficacy in Albanian CHC patients, including those with advanced liver disease.
- The high SVR rate (>93%) supports broader DAA accessibility.
- Removing treatment limitations is essential to meet the WHO goal of hepatitis C eradication by 2030.
Abstract:
Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effective at clearing the infection. In Albania treatment with DAA is limited to patients with liver stiffness F3-F4, and with other co-infections. The objective of this study was to evaluate the efficacy of DAA in Albanian patients with genotypes 1-5, who mostly suffer from advanced liver fibrosis. Material and Methods This is a retrospective study carried out at the University Hospital Center "Mother Teresa", Tirana, during 2014-2019, including treatment-naïve and treatment-experienced patients with genotypes 1-5. All patients were evaluated with elastography and most of them were F3-F4. The primary endpoint involved the patients achieving SVR-12, or undetectable hepatitis C virus/ribonucleic acid (HCV RNA) 12 weeks after the end of treatment. In patients without a genotype, we have used a pangenotypic regimen. Results This study included 207 patients with a mean age of 48.9 ± 13.1 years, 56% male and 44% female; 152 (73%) were genotype 1, 24 were (11.5%) genotype 2, nine were (4.3%) genotype 3, 14 were (6.7%) genotype 4, one was (0.4%) genotype 5, and seven (3.8%) unassigned genotypes. The sustained virologic response (SVR) percentage according to genotype is discussed in the article. The overall SVR score of all the patients in our study was >93%. According to elastography, 127 (66%) were F3-F4, and 80 (38.6%) were F1-F2. Conclusion Treatment with DAA proved to be very effective in our patients; most of them had advanced liver fibrosis as well as compensated or decompensated liver cirrhosis. The overall SVR score of the patients in our study was >93%. Our country needs to treat all patients with chronic hepatitis C without limitations to attain the WHO objective of eradicating this disease by 2030.
