Real-life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study.

Adult Aged Aged, 80 and over Aminoisobutyric Acids Antiviral Agents / therapeutic use Benzimidazoles / therapeutic use Cyclopropanes Drug Therapy, Combination Female Genotype Hepacivirus / drug effects Hepatitis C, Chronic / drug therapy Humans Italy Lactams, Macrocyclic Leucine / analogs & derivatives Liver Cirrhosis / virology Longitudinal Studies Male Middle Aged Proline / analogs & derivatives Prospective Studies Pyrrolidines Quinoxalines / therapeutic use Substance Abuse, Intravenous / complications Sulfonamides / therapeutic use Sustained Virologic Response Young Adult

HCV genotype cirrhosis direct-acting antiviral efficacy substance abuse

Journal

Liver international : official journal of the International Association for the Study of the Liver

ISSN: 1478-3231

Titre abrégé: Liver Int

Pays: United States

ID NLM: 101160857

Informations de publication

Date de publication:
10 2019

Historique:

received: 26 02 2019

revised: 30 05 2019

accepted: 03 06 2019

pubmed: 9 6 2019

medline: 22 9 2020

entrez: 9 6 2019

Statut: ppublish

Résumé

It is paramount to identify predictors of treatment failure with direct antiviral agents in 'field-practice' patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field-practice scenario are scant. The multicentre MISTRAL study enrolled 1177 patients, including PWID, to assess real-life efficacy and safety of GLE/PIB and to identify the predictive factors for this treatment. This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12. A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3. METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID. Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non-substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ The MISTRAL study provides evidence of GLE/PIB efficacy in a field-practice scenario in a highly epidemic HCV area in southern Italy; it unveiled significant differences in genotype distribution among the most underserved and difficult-to-treat patient subgroups including PWID.

Sections du résumé

BACKGROUND AND AIMS

METHODS

This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12.

RESULTS

A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3. METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID. Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non-substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ

CONCLUSIONS

The MISTRAL study provides evidence of GLE/PIB efficacy in a field-practice scenario in a highly epidemic HCV area in southern Italy; it unveiled significant differences in genotype distribution among the most underserved and difficult-to-treat patient subgroups including PWID.

Identifiants

DOI: 10.1111/liv.14170 PMID: 31175707

pubmed: 31175707

doi: 10.1111/liv.14170

doi:

Substances chimiques

Aminoisobutyric Acids 0

Antiviral Agents 0

Benzimidazoles 0

Cyclopropanes 0

Lactams, Macrocyclic 0

Pyrrolidines 0

Quinoxalines 0

Sulfonamides 0

pibrentasvir 2WU922TK3L

Proline 9DLQ4CIU6V

Leucine GMW67QNF9C

glecaprevir K6BUU8J72P

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

1852-1859

Informations de copyright

Références

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