Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)

Background: The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile. Aim: To report the initial experience of patients treated with DAA and their evolution after treatment. Material and Methods: Prospect...

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Autores principales:	Vargas,José Ignacio, Arab,Juan Pablo, Monrroy,Hugo, Labbé,Pilar, Sarmiento,Valeska, Fuster,Felipe, Barrera,Francisco, Benitez,Carlos, Arrese,Marco, Fuster,Francisco, Soza,Alejandro
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Antiviral Agents Chile Drugs Generic Fibrosis Hepatitis C Latin America
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001235
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id	oai:scielo:S0034-98872017001001235
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spelling	oai:scielo:S0034-988720170010012352018-02-16Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)Vargas,José IgnacioArab,Juan PabloMonrroy,HugoLabbé,PilarSarmiento,ValeskaFuster,FelipeBarrera,FranciscoBenitez,CarlosArrese,MarcoFuster,FranciscoSoza,Alejandro Antiviral Agents Chile Drugs Generic Fibrosis Hepatitis C Latin America Background: The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile. Aim: To report the initial experience of patients treated with DAA and their evolution after treatment. Material and Methods: Prospective cohort study, from June 2013 to August 2016 of patients treated with DAA for HCV in three clinical centers. The presence of cirrhosis, clinical and laboratory features; adverse events (AE) and post-treatment changes in liver function were evaluated. Sustained viral response at 12 weeks post-treatment (SVR12) was determined. Results: One hundred six patients aged 58 ± 13 years, 54% males, were included. HCV genotype 1b was present in 88% and 47% had cirrhosis. Treatment regimens were asunaprevir + daclatasvir (DCV) in 17% of patients, paritaprevir / ritonavir / ombitasvir + dasabuvir in 33%, sofosbuvir (SOF) + DCV in 19%, and SOF + ledipasvir in 30%. Twenty five percent of patients used generic drugs. SVR12 was 92.1%, with no differences between generic and brand-name drugs. Serious AE were recorded in 22% of patients, being more common in those with cirrhosis (34% vs 11.5%, p < 0.01). At 12 weeks post-treatment follow-up, there was a decrease in aminotransferase values (p < 0.01), improvement in Child-Pugh score (5.9 vs. 5.5, p = 0.03) and decreased presence of ascites (p = 0.02). Conclusions: In our setting, DAA for HCV was highly effective and safe in non-cirrhotic patients. Hepatic function and inflammation improved at 12 weeks of follow-up. AE were common in patients with cirrhosis, suggesting that these patients should be treated by experienced teams. Generic drugs had similar effectiveness compared to originals.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.10 20172017-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001235es10.4067/S0034-98872017001001235
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Antiviral Agents Chile Drugs Generic Fibrosis Hepatitis C Latin America
spellingShingle	Antiviral Agents Chile Drugs Generic Fibrosis Hepatitis C Latin America Vargas,José Ignacio Arab,Juan Pablo Monrroy,Hugo Labbé,Pilar Sarmiento,Valeska Fuster,Felipe Barrera,Francisco Benitez,Carlos Arrese,Marco Fuster,Francisco Soza,Alejandro Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
description	Background: The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile. Aim: To report the initial experience of patients treated with DAA and their evolution after treatment. Material and Methods: Prospective cohort study, from June 2013 to August 2016 of patients treated with DAA for HCV in three clinical centers. The presence of cirrhosis, clinical and laboratory features; adverse events (AE) and post-treatment changes in liver function were evaluated. Sustained viral response at 12 weeks post-treatment (SVR12) was determined. Results: One hundred six patients aged 58 ± 13 years, 54% males, were included. HCV genotype 1b was present in 88% and 47% had cirrhosis. Treatment regimens were asunaprevir + daclatasvir (DCV) in 17% of patients, paritaprevir / ritonavir / ombitasvir + dasabuvir in 33%, sofosbuvir (SOF) + DCV in 19%, and SOF + ledipasvir in 30%. Twenty five percent of patients used generic drugs. SVR12 was 92.1%, with no differences between generic and brand-name drugs. Serious AE were recorded in 22% of patients, being more common in those with cirrhosis (34% vs 11.5%, p < 0.01). At 12 weeks post-treatment follow-up, there was a decrease in aminotransferase values (p < 0.01), improvement in Child-Pugh score (5.9 vs. 5.5, p = 0.03) and decreased presence of ascites (p = 0.02). Conclusions: In our setting, DAA for HCV was highly effective and safe in non-cirrhotic patients. Hepatic function and inflammation improved at 12 weeks of follow-up. AE were common in patients with cirrhosis, suggesting that these patients should be treated by experienced teams. Generic drugs had similar effectiveness compared to originals.
author	Vargas,José Ignacio Arab,Juan Pablo Monrroy,Hugo Labbé,Pilar Sarmiento,Valeska Fuster,Felipe Barrera,Francisco Benitez,Carlos Arrese,Marco Fuster,Francisco Soza,Alejandro
author_facet	Vargas,José Ignacio Arab,Juan Pablo Monrroy,Hugo Labbé,Pilar Sarmiento,Valeska Fuster,Felipe Barrera,Francisco Benitez,Carlos Arrese,Marco Fuster,Francisco Soza,Alejandro
author_sort	Vargas,José Ignacio
title	Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
title_short	Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
title_full	Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
title_fullStr	Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
title_full_unstemmed	Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)
title_sort	nuevas terapias orales de acción directa para tratamiento de virus de hepatitis c (vhc)
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001001235
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Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC)

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