Background Marketing of different families of direct acting antivirals (DAAS) for hepatitis C virus (HCV) treatment has transformed the disease course, with high functional cure rates, increasing drug combinations in different clinical situations and virus genotypes. The aim was to describe the population infected by HCV receiving treatment with DAAs and to compare the decrease in viral load (VL) with that reported in clinical trials.
Purpose To compare the results obtained in regular clinical practice against the effectiveness results reported in clinical trials for the treatment of chronic hepatitis C (CHC) with DAAs.
Material and methods Retrospective observational study from February to August 2015 of all CHC patients on DAA treatment. Variables included: demographics, HIV coinfection, genotype and initial viral load at week 4, week 12 and 12 weeks after treatment completion in patients who had achieved liver fibrosis stage (F).
Data were obtained from the pharmacy department database, electronic medical records and drug therapy follow-up.
Results 40 patients with CHC received DAA treatment, 68% (27) men, mean age 55.5 years (42–70); 9 (23%) HIV coinfected. Hepatitis virus genotypes were: 1b, 16 (40.0%); 1a, 4 (32.5%); genotype 4, 6 (15%); genotype 4, 3 (10%); and genotype 2, 1 (2.5%). Liver fibrosis stage: F1, 2 (5%), F2, 11 (27.5%), F3, 6 (15%) and F4, 21 (52%), 11 patients had been previously treated. 23 (57.7%) had received ledipasvir/sofosbuvir with or without ribavirin, 7 (17.5%) simeprevir/sofosbuvir and 4 (10.0%) dasabuvir+ombitasvir/paritaprevir/ritonavir; the remaining patients received other drug combinations. At week 4 of treatment, 27 (67.5%) had undetectable VL, 8 (20%) VL <15 and 5 detectable VL. The 22 (55%) patients who had reached week 12 (treatment completion) had undetectable VL and all patients (6) who were at week 12 from treatment completion also presented undetectable VL.
Conclusion The percentage of patients with undetectable VL at week 4 was lower than that reported in clinical trials. At week 12, all patients who had completed treatment had undetectable VL, with results comparable with those found in clinical trials.
No conflict of interest.
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