Article Text
Abstract
Background The European Medicines Agency authorised glecaprevir/pibrentasvir combination for treatment of hepatitis C virus (HCV) infection in July 2017. Treating hospital patients and the institutionalised population is essential in reducing transmission of virus infection.
Purpose To evaluate the effectiveness and tolerance of HCV patients treated with glecaprevir/pibrentasvir in hospital and penitentiary centres.
Material and methods Descriptive and retrospective study of HCV patients receiving glecaprevir/pibrentasvir from November 2017 to October 2018. Hospital and prison patients were selected. HCV prison patients were diagnosed and treated by the hospital and information was included in electronic medical history. Hospital and prison data were collected from electronic medical records: age, gender, patient type (naïve/pretreated), hepatic fibrosis stage, HCV genotype (G), medical departments, treatment duration, loss of follow-up after ending treatment, withdrawal treatments and HCV recurrence. Effectiveness was measured by end of treatment response (EOT) and sustained virologic response at week 12 (SVR12). EOT was defined as absence of HCV-RNA at end of treatment and SVR12 was determined as undetectable HCV-RNA 12 weeks after stopping treatment. Tolerance was assessed by related adverse effects (RA).
Results A total of 114 patients with a mean age of 51.7 (29–73) years were included, 101 (88.6%) males. Of all of them, 96 (84.2%) of patients were naïve. Hepatic fibrosis stage recorded: 10 (8.8%) F4, nine (7.9%) F3, 15 (13.1%) F2, 80 (70.2%) F0–F1. HCV genotype distribution: 44 (38.6%) G1a, 21 (18.5%) G1b, four (3.5%) G2, 21 (18.4%) G3 and 24 (21%) G4. Glecaprevir/pibrentasvir prescriptions: 30 (26.3%) internal medicine-infectious department, 33 (29%) digestive and 51 (44.7%) penitentiary centres. Duration of treatment was 8 weeks for 104 (91.4%) patients and 12 weeks for 10 (8.6%) (all cirrhotic patients). There were six (5.2%) loss of follow-up after ending treatment, being all digestive department patients. Withdrawal treatments: two (1.7%) patients (all prison patients). There was one (0.9%) HCV recurrence (an interferon-ribavirin-pretreated patient). One-hundred and eleven (97.5%) patients achieved EOT and 109 (96.1%) had RVS12. Seven (6.1%) patients reported nine RA: five (55.6%) asthaenia, two (22.2%) headache, one (11.1%) anxiety and one (11.1%) pruritus.
Conclusion High rates of EOT and RVS12 in real-world patients were observed. Few patients reported RA and all associated withdrawal treatments were recorded in the population of the penitentiary centres.
References and/or acknowledgements None.
No conflict of interest.