Background and Importance According to the ‘Global health sector strategy on viral hepatitis 2016-2021’ published by the World Health Organization (WHO), one of the objectives to be achieved before 2030 is to detect 90% of people infected by Hepatitis C virus (HCV) and provide treatment to 80% of them.
Aim and Objectives To describe and analyse the current situation of HCV-infected patients treated with direct-acting antivirals (DAAs) in a second-level hospital.
Material and Methods A retrospective observational study of all patients treated with DAAs in 2021 was conducted. Data collected from the electronical medical history and electronic prescription programme were: demographic data, date and setting of detection of HCV infection, coinfection with human immunodeficiency virus (HIV) and/or hepatitis B virus (HBV), viral load, degree of fibrosis, previous treatments for HCV, therapeutic option used, tolerance and effectiveness).
Results Thirty-seven patients (70% men) were included, with a median age of 56 years [interquartile range (IQR): 49-65]. The median time from diagnosis to start of treatment was 49 months (IQR: 2-145). Only 5 patients (13%) had been previously treated.
Diagnosis was made by the general practitioner (25 patients), a care centre for drug addicts (4 patients) and external consultations of different specialties (8 patients). Three patients were coinfected with HIV. Regarding the degree of fibrosis, F0-F1: 19 patients, F2: 5 patients, F3-F4: 12 patients (6 with cirrhosis). The median viral load at the start of treatment was 3,870,000 IU/ml (IQR: 1,160,000-6,430,000).
The therapeutic options used included sofosbuvir/velpatasvir for 12 weeks (25 patients), sofosbuvir/velpatasvir for 24 weeks (1 patient with liver cirrhosis with previous decompensation, pretreated with peginterferon/ribavirin), glecaprevir/pibrentasvir for 8 weeks (9 patients), and ledipasvir/sofosbuvir 8 weeks (2 patients). There was no therapeutic failure requiring rescue with another DAA. No patient suffered adverse effects related to antiviral treatment.
Conclusion and Relevance Most of the patients were detected through the screening programs currently implemented in the different care settings of our health area, which may allow achieving the objectives of the WHO.
With these programs an early detection of the infection was achieved, which leads to less liver damage.
All our patients were treated according to the pharmacotherapeutic options officially recognised as more cost-effective.
Conflict of Interest No conflict of interest