High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV-infected patients treated in a real-life setting.
DAA
SVR
antiviral treatment
chronic hepatitis C
liver cirrhosis
Journal
Journal of viral hepatitis
ISSN: 1365-2893
Titre abrégé: J Viral Hepat
Pays: England
ID NLM: 9435672
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
23
05
2020
revised:
21
08
2020
accepted:
18
11
2020
pubmed:
12
12
2020
medline:
1
9
2021
entrez:
11
12
2020
Statut:
ppublish
Résumé
In routine clinical practice, hepatitis C virus-infected patients can prematurely discontinue the prescribed regimen for several reasons. The aim of our study was to investigate sustained virological response (SVR12) rates in patients who prematurely discontinued directly acting antiviral (DAA) regimens and to assess the shortest effective duration of DAA able to lead to SVR12. We retrospectively collected the SVR rates of patients, registered in the NAVIGATORE-Lombardia Network database from January 2015, who discontinued DAAs before the predefined end of treatment. Overall, we included 365 patients, males were the majority (213, 58.4%), mean age was 60.5 years, and 53 (14.5%) patients were HIV-co-infected. Liver cirrhosis was observed in 251 (68.8%) subjects, and the most represented genotypes were 1b (n = 168, 46%) and 3 (n = 59, 16.2%). DAA was discontinued a median of 1 (IQR 1-4) weeks before the predefined EOT, with 164 (44.9%) patients stopping DAAs at least 2 weeks before the planned schedule. In patients with F0-F3 liver fibrosis, lower rates of SVR12 were observed in patients treated for <4 weeks: 50% (n = 2/4) vs. 99.1% (n = 109/110) for ≥4 weeks, p = 0.003. In patients with liver cirrhosis, lower rates of SVR12 were observed in patients treated <8 weeks: 83.3% (n = 25/30) vs. 94.6% (n = 209/221) for ≥8 weeks, p = 0.038. Despite premature discontinuation of DAA, high SVR12 rates were observed in a real-life setting for treatment lasting at least 4 weeks in patients with liver fibrosis F0-F3 and 8 weeks in those with liver cirrhosis. On this basis, feasibility of reducing DAA treatment duration should be explored in randomized clinical trials.
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
558-568Investigateurs
Marta Borghi
(M)
Roberta Soffredini
(R)
Riccardo Perbellini
(R)
Andrea Gori
(A)
Valentina Ferroni
(V)
Maria Colpani
(M)
Matteo Manini
(M)
Giuliana Cologni
(G)
Sergio Lazzaroni
(S)
Maria Vinci
(M)
Stella De Nicola
(S)
Chiara Mazzarelli
(C)
Teresa Angelini Zucchetti
(T)
Viviana Picciotto
(V)
Massimo Puoti
(M)
Roberto Rossotti
(R)
Simona Landonio
(S)
Carlo Federico Magni
(CF)
Giuliano Rizzardini
(G)
Elisa Colella
(E)
Paola Columpsi
(P)
Alessandra Gambaro
(A)
Anna Spolti
(A)
Carlo Magnani
(C)
Paolo Viganò
(P)
Maurizio Mena
(M)
Massimo Villa
(M)
Ilaria Caramma
(I)
Cristina Basilico
(C)
Francesca Capelli
(F)
Sara Biagiotti
(S)
Antonino Mazzone
(A)
Valeria Saladino
(V)
Maria Pia Baldacci
(MP)
Federico Gatti
(F)
Luca Varalli
(L)
Lorenzo Morini
(L)
Barbara Menzaghi
(B)
Maddalena Farinazzo
(M)
Rossella Meli
(R)
Maria Corina Plaz Torres
(MC)
Mariagrazia Rumi
(M)
Ilaria Fanetti
(I)
Clara Dibenedetto
(C)
Daniel Orellana
(D)
Paola Zermiani
(P)
Massimo Zuin
(M)
Anna De Bona
(A)
Antonella D'Arminio Monforte
(A)
Andrea Capretti
(A)
Maria Teresa Taddei
(MT)
Marco Soncini
(M)
Angiola Spinetti
(A)
Stefania Zaltron
(S)
Marie Graciella Pigozzi
(MG)
Angelo Rossini
(A)
Angelo Pan
(A)
Sarah Dal Zoppo
(S)
Alessia Zoncada
(A)
Massimo Memoli
(M)
Stefania Salpietro
(S)
Hasson Hamid
(H)
Emanuela Messina
(E)
Alberto Eraldo Colombo
(AE)
Omar Giglio
(O)
Paolo Bonfanti
(P)
Chiara Molteni
(C)
Natalia Terreni
(N)
Giancarlo Spinzi
(G)
Simone Conforti
(S)
Elisabetta Clerici
(E)
Fernanda Menozzi
(F)
Elisabetta Buscarini
(E)
Riccardo Centenaro
(R)
Ada Corbellini
(A)
Franco Noventa
(F)
Sara Gritti
(S)
Pietro Giani
(P)
Informations de copyright
© 2020 John Wiley & Sons Ltd.
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