Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorLOURENCO, Mariana Sandoval
dc.contributor.authorZITELLI, Patricia Momoyo Y.
dc.contributor.authorCUNHA-SILVA, Marlone
dc.contributor.authorOLIVEIRA, Arthur Ivan N.
dc.contributor.authorOLIVEIRA, Claudia P.
dc.contributor.authorSEVA-PEREIRA, Tiago
dc.contributor.authorCARRILHO, Flair Jose
dc.contributor.authorPESSOA, Mario G.
dc.contributor.authorMAZO, Daniel F.
dc.date.accessioned2022-08-12T17:07:19Z
dc.date.available2022-08-12T17:07:19Z
dc.date.issued2022
dc.description.abstractBACKGROUND Hepatitis C virus (HCV) treatment has undergone major changes in recent years. Previous interferon-based therapies have been replaced by oral direct-acting antivirals (DAA) regimens, with high sustained virologic response (SVR) rates, and a lower incidence of adverse events (AEs). AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in Brazil. METHODS This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C (CHC), undergoing treatment with interferon-free regimens from November 2015 to November 2019. The therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of treatment. Demographic, anthropometric, clinical, and laboratory variables were evaluated. SVRs were assessed at 12 to 24 wk after therapy by intention-to-treat (ITT), and modified ITT (m-ITT) analysis. AEs and serious adverse events (SAEs) were registered. In the statistical analysis, a P value of < 0.05 was considered significant. RESULTS The mean age was 56.88 years, with 415 (78.5%) being HCV genotype 1, followed by genotype 3 (20.1%). Moreover, 306 (57.5%) subjects had cirrhosis, and a third of them had decompensated cirrhosis. Sofosbuvir (SOF) plus daclatasvir ribavirin was the most frequently used treatment (66.9%), followed by SOF plus simeprevir (21.2%). The overall ITT SVR was 92.6% (493/532), while the m-ITT SVR was 96.8% (493/509). Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy (OR: 4.320; 95%CI: 1.920-9.721, P = 0.0004), presence of esophageal varices (OR: 2.381; 95%CI: 1.137-4.988, P = 0.0215), previous portal hypertensive bleeding (OR: 2.756; 95%CI: 1.173-6.471, P = 0.02), higher model for end-stage liver disease scores (OR: 1.143, 95%CI: 1.060-1.233, P = 0.0005), lower serum albumin levels (OR: 0.528, 95%CI: 0.322-0.867, P = 0.0115), higher serum creatinine (OR: 1.117, 95%CI: 1.056-1.312, P = 0.0033), and international normalized ratio (INR) levels (OR: 5.542, 95%CI: 2.023-15.182, P = 0.0009). AEs were reported in 41.1% (211/514) of patients, and SAEs in 3.7%. The female gender, higher body mass index, esophageal varices, higher INR values, and longer treatment duration were independently associated with AE occurrence. CONCLUSION Treatment with oral DAAs attains a high SVR rate, with fewer SAEs in a real-life cohort of subjects with CHC, from two tertiary university centers in Brazil.eng
dc.description.indexPubMedeng
dc.identifier.citationWORLD JOURNAL OF HEPATOLOGY, v.14, n.1, 2022
dc.identifier.doi10.4254/wjh.v14.i1.195
dc.identifier.issn1948-5182
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/48400
dc.language.isoeng
dc.publisherBAISHIDENG PUBLISHING GROUP INCeng
dc.relation.ispartofWorld Journal of Hepatology
dc.rightsopenAccesseng
dc.rights.holderCopyright BAISHIDENG PUBLISHING GROUP INCeng
dc.subjectChronic hepatitis Ceng
dc.subjectAntiviral agentseng
dc.subjectHepatitis C viruseng
dc.subjectSustained virologic responseeng
dc.subjectLiver cirrhosiseng
dc.subjectSafetyeng
dc.subject.otherdaclatasvir plus sofosbuvireng
dc.subject.othergenotype 1 infectioneng
dc.subject.otherall-cause mortalityeng
dc.subject.othervirus-infectioneng
dc.subject.othertherapyeng
dc.subject.othersafetyeng
dc.subject.otheragentseng
dc.subject.otherribavirineng
dc.subject.othercirrhosiseng
dc.subject.wosGastroenterology & Hepatologyeng
dc.titleDirect-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazileng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalLOURENCO, Mariana Sandoval:Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Div Gastroenterol, Rua Carlos Chagas 420, BR-13083878 Sao Paulo, Brazil
hcfmusp.author.externalCUNHA-SILVA, Marlone:Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Div Gastroenterol, Rua Carlos Chagas 420, BR-13083878 Sao Paulo, Brazil
hcfmusp.author.externalSEVA-PEREIRA, Tiago:Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Div Gastroenterol, Rua Carlos Chagas 420, BR-13083878 Sao Paulo, Brazil
hcfmusp.author.externalMAZO, Daniel F.:Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Div Gastroenterol, Rua Carlos Chagas 420, BR-13083878 Sao Paulo, Brazil
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcPATRICIA MOMOYO YOSHIMURA ZITELLI
hcfmusp.contributor.author-fmusphcARTHUR IVAN NOBRE OLIVEIRA
hcfmusp.contributor.author-fmusphcCLAUDIA PINTO MARQUES SOUZA DE OLIVEIRA
hcfmusp.contributor.author-fmusphcFLAIR JOSE CARRILHO
hcfmusp.contributor.author-fmusphcMARIO GUIMARAES PESSOA
hcfmusp.description.issue1
hcfmusp.description.volume14
hcfmusp.origemWOS
hcfmusp.origem.pubmed35126848
hcfmusp.origem.scopus2-s2.0-85123857542
hcfmusp.origem.wosWOS:000802508200011
hcfmusp.publisher.cityPLEASANTONeng
hcfmusp.publisher.countryUNITED STATESeng
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