Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain

Maheeba Abdulla,1 Hamed Ali,2 Hafsa Nass,2 Jawad Khamis,2 Jehad AlQamish11Gastroenterology and Hepatology, Salmaniya Medical Complex, Manama, Bahrain; 2Medical Department, Salmaniya Medical Complex, Manama, BahrainPurpose: The introduction of direct-acting antivirals (DAAs) has revolutionized the tr...

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Autores principales:	Abdulla M, Ali H, Nass H, Khamis J, AlQamish J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	HCV DAAs Treatment Sustained viral response Cirrhosis Liver disease Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/eb27ec9cdce2439e82aef05672a0c678
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spelling	oai:doaj.org-article:eb27ec9cdce2439e82aef05672a0c6782021-12-02T13:18:24ZEfficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain1179-1535https://doaj.org/article/eb27ec9cdce2439e82aef05672a0c6782019-05-01T00:00:00Zhttps://www.dovepress.com/efficacy-of-direct-acting-antiviral-therapy-for-hepatitis-c-viral-infe-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Maheeba Abdulla,1 Hamed Ali,2 Hafsa Nass,2 Jawad Khamis,2 Jehad AlQamish11Gastroenterology and Hepatology, Salmaniya Medical Complex, Manama, Bahrain; 2Medical Department, Salmaniya Medical Complex, Manama, BahrainPurpose: The introduction of direct-acting antivirals (DAAs) has revolutionized the treatment of chronic hepatitis C viral (HCV) infection. This study aims to establish real-world treatment efficacy of Sofosbuvir-based (SOF-B) and Ombitasvir/Paritaprevir/Ritonavir-based (OPR-B) regimens.Patients and methods: This prospective, non-randomized observational real-life study was conducted in Salmaniya Medical Complex, Bahrain, and included consecutive patients with chronic HCV infection (genotypes 1–4) who were treated with direct-acting antivirals. Sustained virologic response to therapy was assessed at week 12 post end of treatment (SVR12).Results: Of the 167 patients included, 60.5% (n=101) were treated with SOF-B and 39.5% (n=66) with OPR-B regimens for 12 weeks (n=148; 88.6%) or 24 weeks (n=19; 11.4%). SVR12 was achieved in 156 (93.4%) patients, 4 patients failed to achieve SVR despite completion of treatment, and 7 patients discontinued treatment due to non-compliance and were included in the analysis on an intention-to-treat basis. There was no difference between SOF-B and OPR-B regimens (95/101; 94.1%) and (61/66; 92.4%), respectively (p=0.68). However, SVR12 rates were significantly higher in patients without liver cirrhosis (103/104; 99.0%) compared to patients with cirrhosis (53/63; 84.1%; p<0.001), and in patients who received 12-week-regimen (141/148; 95.3%) compared to those who received 24-week regimen (15/19; 78.9%; p<0.024). However, logistic regression analysis identified cirrhosis at baseline to be the only independent predictor of non-SVR12 (OR: 16.1, 95% confidence interval 1.96–131.91, p=0.01). Apart from Hb, INR, and ALP, all other laboratory parameter improved following treatment (p<0.05).Conclusion: Both SOF-B and OPR-B regimens achieved high SVR12 rates in this real-life cohort of patients with chronic HCV infection, similar to what is reported in other real-world studies. Cirrhosis was the only independent predictor of poor response.Keywords: HCV, DAAs, treatment, sustained viral response, cirrhosis, liver diseaseAbdulla MAli HNass HKhamis JAlQamish JDove Medical PressarticleHCVDAAsTreatmentSustained viral responseCirrhosisLiver diseaseDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 11, Pp 69-78 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	HCV DAAs Treatment Sustained viral response Cirrhosis Liver disease Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	HCV DAAs Treatment Sustained viral response Cirrhosis Liver disease Diseases of the digestive system. Gastroenterology RC799-869 Abdulla M Ali H Nass H Khamis J AlQamish J Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
description	Maheeba Abdulla,1 Hamed Ali,2 Hafsa Nass,2 Jawad Khamis,2 Jehad AlQamish11Gastroenterology and Hepatology, Salmaniya Medical Complex, Manama, Bahrain; 2Medical Department, Salmaniya Medical Complex, Manama, BahrainPurpose: The introduction of direct-acting antivirals (DAAs) has revolutionized the treatment of chronic hepatitis C viral (HCV) infection. This study aims to establish real-world treatment efficacy of Sofosbuvir-based (SOF-B) and Ombitasvir/Paritaprevir/Ritonavir-based (OPR-B) regimens.Patients and methods: This prospective, non-randomized observational real-life study was conducted in Salmaniya Medical Complex, Bahrain, and included consecutive patients with chronic HCV infection (genotypes 1–4) who were treated with direct-acting antivirals. Sustained virologic response to therapy was assessed at week 12 post end of treatment (SVR12).Results: Of the 167 patients included, 60.5% (n=101) were treated with SOF-B and 39.5% (n=66) with OPR-B regimens for 12 weeks (n=148; 88.6%) or 24 weeks (n=19; 11.4%). SVR12 was achieved in 156 (93.4%) patients, 4 patients failed to achieve SVR despite completion of treatment, and 7 patients discontinued treatment due to non-compliance and were included in the analysis on an intention-to-treat basis. There was no difference between SOF-B and OPR-B regimens (95/101; 94.1%) and (61/66; 92.4%), respectively (p=0.68). However, SVR12 rates were significantly higher in patients without liver cirrhosis (103/104; 99.0%) compared to patients with cirrhosis (53/63; 84.1%; p<0.001), and in patients who received 12-week-regimen (141/148; 95.3%) compared to those who received 24-week regimen (15/19; 78.9%; p<0.024). However, logistic regression analysis identified cirrhosis at baseline to be the only independent predictor of non-SVR12 (OR: 16.1, 95% confidence interval 1.96–131.91, p=0.01). Apart from Hb, INR, and ALP, all other laboratory parameter improved following treatment (p<0.05).Conclusion: Both SOF-B and OPR-B regimens achieved high SVR12 rates in this real-life cohort of patients with chronic HCV infection, similar to what is reported in other real-world studies. Cirrhosis was the only independent predictor of poor response.Keywords: HCV, DAAs, treatment, sustained viral response, cirrhosis, liver disease
format	article
author	Abdulla M Ali H Nass H Khamis J AlQamish J
author_facet	Abdulla M Ali H Nass H Khamis J AlQamish J
author_sort	Abdulla M
title	Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
title_short	Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
title_full	Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
title_fullStr	Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
title_full_unstemmed	Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain
title_sort	efficacy of direct-acting antiviral therapy for hepatitis c viral infection. real-life experience in bahrain
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/eb27ec9cdce2439e82aef05672a0c678
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Efficacy of direct-acting antiviral therapy for hepatitis C viral infection. Real-life experience in Bahrain

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