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, 10 (1), 88-94

Efficacy of Direct-Acting Antiviral Treatment for Chronic Hepatitis C: A Single Hospital Experience

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Efficacy of Direct-Acting Antiviral Treatment for Chronic Hepatitis C: A Single Hospital Experience

Rena Kaneko et al. World J Hepatol.

Abstract

Aim: To evaluate the efficacy of direct-acting antivirals (DAAs) in Kanto Rosai Hospital.

Methods: All patients with hepatitis C virus (HCV) who underwent DAA prescription were enrolled in this study. The present study was a single center retrospective analysis using patients infected with HCV genotype 1 or 2. Resistance analysis was performed by using direct sequencing and cycleave PCR in genotype 1 patients treated with interferon (IFN)-free DAA. The primary endpoint was sustained virologic response at 12 wk after therapy (SVR12).

Results: A total of 117 patients participated in the study, including 135 with genotype 1 and 42 with genotype 2. Of the 135 patients with genotype 1, 16 received protease inhibitor + IFN + ribavirin and all achieved SVR. Of the 119 patients who received IFN-free DAA (in different combinations), 102 achieved SVR and 9 failed (7/9 were on daclatasvir/asunaprevir and 2/9 on ledipasvir/sofosbuvir). Efficacy analysis was done only for 43 patients who received daclatasvir/asunaprevir. From this analysis, Y93 resistance-associated substitutions were significantly correlated with SVR.

Conclusion: The SVR rate was 98% for genotype 1 and 100% for genotype 2. However, caution is needed for HCV NS5A resistance-associated substitutions that are selected by HCV NS5A inhibitors because cerebrovascular adverse events are induced by some DAA drugs.

Keywords: Direct-acting antivirals; Hepatitis C; Resistance-associated substitutions; Sustained viral response.

Conflict of interest statement

Conflict-of-interest statement: The authors declare no potential conflict of interest.

Figures

Figure 1
Figure 1
SVR rates for NS5A resistance-associated substitutions and each interferon-free agent. The number above each column is the number of cases with SVR (numerator) and total cases (denominator). Two relapsed patients with wild-type Y93, 1 with Y93 hetero and 3 relapsed patients with wild-type L31 were treated with DCV/ASV. Another 6 patients that failed to achieve SVR with DAA treatment had not obtained NS5A RASs prior to treatment. Another patient had no relapse regardless of the presence or absence of RASs. DAA: Direct-acting antivirals; DCV/ASV: Daclatasvir/asunaprevir; RAS: Resistance-associated substitution; SVR: Sustained virologic response.

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