The Impact of Direct-Acting Antivirals in the Hepatitis C-Sustained Viral Response in Human Immunodeficiency Virus-Infected Patients With Ongoing Barriers to Care
نویسندگان
چکیده
Background. Access to hepatitis C virus (HCV) medications for human immunodeficiency virus (HIV)-infected patients with ongoing barriers to care is restricted by healthcare payers in the absence of HCV treatment outcomes data in the era of direct-acting antivirals (DAA). Methods. Retrospective analysis of HCV treatment outcomes using interferon (IFN)-free DAA regimens and an inclusive treatment protocol in an urban HIV clinic where ongoing barriers to care (drug or alcohol use, psychiatric disease, and/or unstable housing) are common. Then, using logistic regression analysis, we compared the proportion of HIV-infected patients who achieved HCV sustained viral response (SVR) in the pegylated-IFN plus ribavirin (PEG-IFN/RBV, 2008-2011), pegylated-IFN plus ribavirin and telaprevir (PEG-IFN/RBV/PI, 2011-2013), and IFN-free DAA therapy eras (2014). Results are displayed using forest plots. Results. The proportion of patients who achieved HCV SVR in the PEG-IFN/RBV, PEG-IFN/RBV/PI, and IFN-free DAA therapy eras increased from 38.4% (95% confidence interval [CI], 23.2-53.7) and 48% (95% CI, 28.4-67.6) to 83.3% (95% CI, 70.0-96.7), respectively. Similar proportions of patients with ongoing barriers to care were treated during the PEG-IFN/RBV (25 of 39 [64%]), PEG-IFN/RBV/PI (14 of 25 [56%]), and IFN-free DAA (16 of 30 [53%]) eras. Hepatitis C virus SVR among patients with ongoing barriers to care improved from 40% (95% CI, 21-59) to 76.5% (95% CI, 56-97) in the PEG-IFN/RBV and IFN-free DAA eras, respectively. After stratification for factors associated with HCV SVR such as HCV genotype and cirrhosis, HCV SVR were similar in patients regardless of the presence of ongoing barriers to care. Conclusions. Using IFN-free DAA and an inclusive HCV treatment protocol, 76.5% of HIV/HCV-treated patients with ongoing barriers to care achieved HCV SVR.
منابع مشابه
الگوهای جدید درمانی برای عفونت ویروس هپاتیت C
Hepatitis C virus (HCV) infection has affected approximately 180 million people across the world. In most cases, HCV-infection remains chronic, which expose patients at high risk of cirrhosis and hepatocellular carcinoma. The rates of disease incidence and mortality diminish as a result of successful treatment of HCV infection. Until the recent years, despite the associated toxicities and l...
متن کاملDetection of Pre-treatment mutations leading to resistance to direct hepatitis C virus blocking drugs in patients with chronic hepatitis C
Background and objective: Human is the only host of hepatitis C virus. This virus has a positive single stranded RNA and lipoprotein envelop that has 7 confirmed genotypes. According to studies, genotypes 1a, 3a and 1b are the most common genotypes in Iran. No effective vaccine against HCV infection has been developed instead, advances in antiviral treatment using drugs that directly affect spe...
متن کاملImmunological Response and Prevalence of Occult HCV Genotype 4 Among Patients Receiving Direct-Acting Antiviral (DAA) Drugs: A Cross-sectional Study
Background and Objective: Infection with the hepatitis C virus (HCV) is an endemic public health problem with long-term consequences, especially in Egypt. Egypt has one of the highest incidence rates of HCV worldwide. The current cross-sectional study aims to determine how prevalent occult HCV infection is and how it affects the individual's immune response. Methods: The studied adult patient...
متن کاملDetection of SENV Virus in Healthy, Hepatitis B- and Hepatitis C-Infected Individuals in Yazd Province, Iran
Background: SEN virus (SENV) is the latest virus proposed as a cause of unknown hepatitis cases. Among nine detected genotypes of the virus, genotypes D and H are more frequent in hepatitis cases of unknown origin. The aim of this study was to determine the frequency of SENV-D and SENV-H genotypes in the sera of healthy individuals and hepatitis B and C patients. Methods: Totally, 200 serum sam...
متن کاملNew treatment of hepatitis C (Direct Acting Antiviral)
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Clinical care for the patients with HCV-related liver disease has advanced considerably thanks to an enhanced understanding of the pathophysiology of the disease, and because of developments in diagnostic procedures and improvements in therapy an...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 2 شماره
صفحات -
تاریخ انتشار 2015