Background and importance The approach to chronic hepatitis C (HCC) has changed. Treatments with more than 90% effectiveness, fixed length treatments, daily dose and a good safety profile make treatment easier to handle.
Aim and objectives To analyse the use of direct acting antivirals (DAA) in the treatment of hepatitis C virus infection in a tertiary hospital.
Material and methods A retrospective, observational and descriptive study was conducted in patients who initiated treatment for HCC between June 2017 and December 2018. Both monoinfected and coinfected HIV patients were included, having completed DAA treatment. We collected demographic (gender, age) and clinical (virus genotype, fibrosis degree, mono- or coinfected, treatment and length of treatment, previous treatments in the case of relapse) variables. As an effectiveness variable, we set sustained viral response (SVR) at week 12 after finishing treatment, or undetectable viral load in those patients who did not achieve a SVR.
Data were obtained from the pharmacotherapeutic management programmes Silicon and SAP.
Results A total of 146 patients. mean age 54 years. were included. There was 34.93% women, 25.34% coinfected and 88.36% naïve.
The most frequent genotype (G) was G1a (31.94%), G1b, 29.86% and G3, 19.44%. Depending on hepatic damage, patients presented with different levels of fibrosis (F): F0–1, 66.44%; F2, 15.75%; F3, 6.16%; F4, 5.48%; and cirrhosis, 2.05%. Treatments were glecaprevir/pibrentasvir in 57.53%, sofosbuvir/velpatasvir in 23.29% and elbasvir/grazoprevir in 14.38%. Length of treatment was chosen according to what was said in the technical.
Effectiveness (SVR) evaluated 12 weeks after finishing treatment or undetectable viral load after finishing treatment in monoinfected patients was 75.93% and 24.07%, respectively. Regarding coinfection, we could not follow-up with one patient and the other patient’s results are still pending (SVR 92.11%). Relapse was detected in patients who had been previously treated with ombitasvir/paritaprevir/ritonavir+dasabuvir (2.05%), sofobuvir/ledipasvir (0.68%, n=1) and elbasvir/grazoprevir (0.68%), and reinfection was detected in a patient previously treated with sofosbuvir/daclatasvir. Relapses were treated with sofosbuvir/velpatasvir/voxilaprevir (2.74%).
Conclusion and relevance Use of DAA was common in our hospital. Effectiveness data and population characteristics were equal to those obtained in the available bibliography. It is crucial to confirm SVR in week 12 after finishing treatment to make sure the disease has been cured.
References and/or acknowledgements No conflict of interest.
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