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Chronic hepatitis c treatment

Emma Hathorn, Ahmed M Elsharkawy
Genotype 4 chronic hepatitis C (G4 HCV) accounts for 13% of worldwide HCV infections; with 10 million people infected with the virus across the world. Up to the end of 2013, the only treatment option for G4 HCV was treatment with pegylated interferon and ribavirin for 24-48 weeks. Since late 2013, treatment of G4 HCV has been transformed by the licensing of many directly acting antiviral agents (DAA). It is an exciting time to be involved in the management of HCV generally and G4 particularly. Interferon-free DAA regimens are now a reality for G4 HCV...
2016: BMJ Open Gastroenterology
Qing Wang, Andrea De Luca, Colette Smith, Robert Zangerle, Helen Sambatakou, Fabrice Bonnet, Colette Smit, Philipp Schommers, Alicia Thornton, Juan Berenguer, Lars Peters, Vincenzo Spagnuolo, Adriana Ammassari, Andrea Antinori, Eugenia Quiros Roldan, Cristina Mussini, Jose M Miro, Deborah Konopnicki, Jan Fehr, Maria A Campbell, Monique Termote, Heiner C Bucher
Background: Non-Hodgkin lymphoma (NHL) is the most common AIDS-defining condition in the era of antiretroviral therapy (ART). Whether chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection promote NHL in HIV-infected patients is unclear. Objective: To investigate whether chronic HBV and HCV infection are associated with increased incidence of NHL in HIV-infected patients. Design: Cohort study. Setting: 18 of 33 cohorts from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE)...
October 18, 2016: Annals of Internal Medicine
Kayo Sugimoto, Soo Ki Kim, Soo Ryang Kim, Mana Kobayashi, Airi Kato, Eri Morimoto, Susumu Imoto, Chi Wan Kim, Yasuhito Tanaka, Masatoshi Kudo, Yoshihiko Yano, Yoshitake Hayashi
OBJECTIVES: The efficacy of sofosbuvir plus ribavirin (RBV) treatment for hepatitis C virus (HCV) genotype 2 focusing on virological response was compared with that of pegylated interferon (peg-IFN) plus RBV treatment. Safety of the former focusing on the decline in hemoglobin levels was compared with that of the latter and assessed in terms of age and inosine triphosphatase (ITPA). METHODS: Patients (n = 17) receiving sofosbuvir plus RBV and those (n = 24) receiving peg-IFN plus RBV diagnosed with chronic HCV genotype 2 were enrolled in this study, and the efficacy and safety of both treatments were assessed...
2016: Digestive Diseases
Satoru Hagiwara, Naoshi Nishida, Tomohiro Watanabe, Toshiharu Sakurai, Hiroshi Ida, Yasunori Minami, Masahiro Takita, Tomohiro Minami, Mina Iwanishi, Hirokazu Chishina, Kazuomi Ueshima, Yoriaki Komeda, Tadaaki Arizumi, Masatoshi Kudo
OBJECTIVE: Treatment for chronic hepatitis C has recently developed in a very rapid manner. In Japan, in September 2014, IFN-free asunaprevir (ASV) and daclatasvir (DCV) became available for combination therapy. We report the treatment outcomes achieved at our hospital using this combination therapy. METHODS: Sustained virological response (SVR) 24 could be evaluated in 120 of 125 patients with chronic liver disease type C who visited our hospital and were treated with ASV/DCV after September 2014, and these patients were analyzed...
2016: Digestive Diseases
Robert Flisiak, Mitchell Shiffman, Juan Arenas, Hugo Cheinquer, Igor Nikitin, Yuping Dong, Khurram Rana, Subasree Srinivasan
BACKGROUND: A randomized, double-blind, multinational, phase 3 study was conducted comparing the efficacy and safety of peginterferon lambda-1a (Lambda)/ribavirin (RBV)/telaprevir (TVR) vs. peginterferon alfa-2a (Alfa)/RBV/TVR in patients with chronic hepatitis C virus (HCV) genotype-1 (GT-1) infection. METHODS: Patients (treatment-naïve or relapsers on prior Alfa/RBV treatment) were randomly assigned in a 2:1 ratio to receive Lambda/RBV/TVR or Alfa/RBV/TVR. Total duration of treatment was either 24 or 48 weeks (response-guided treatment), with TVR administered for the first 12 weeks...
2016: PloS One
Zobair M Younossi, Atsushi Tanaka, Yuichiro Eguchi, Young-Suk Lim, Ming-Lung Yu, Norifumi Kawada, Yock Young Dan, Craig Brooks-Rooney, Francesco Negro, Mario U Mondelli
Between 80 and 115 million people worldwide are chronically infected with hepatitis C virus, with 60-90% of these being undiagnosed. Untreated chronic hepatitis C (CHC) is associated with progressive liver disease, cirrhosis, hepatocellular carcinoma and liver-related mortality. A number of extrahepatic manifestations are also reported in CHC patients, further adding to the burden of the disease. CHC also impacts patients in terms of lower health-related quality of life, higher levels of fatigue and reduced productivity...
October 17, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Sylvie Deuffic-Burban, Jérôme Boursier, Vincent Leroy, Yazdan Yazdanpanah, Laurent Castera, Philippe Mathurin
BACKGROUND AND AIMS: This study quantifies the impact of different rules for access to treatment, ranging from targeted therapy in patients with ⩾F3 in Italy, ⩾ severe F2 in France, and universal therapy in UK, using noninvasive diagnostic tests of fibrosis to determine targeted therapy. METHODS: A country-specific Markov model predicts outcomes with targeted and universal interferon-free therapy vs. no treatment in the three countries. Targeted therapy was initiated in patients ⩾F2 (F2-scenario) or ⩾F3 (F3-scenario) evaluated by noninvasive diagnostic tests according to the real stage of fibrosis...
October 12, 2016: Journal of Hepatology
J E Edwards, C LaCerte, T Peyret, N H Gosselin, J F Marier, A F Hofmann, D Shapiro
Obeticholic acid (OCA), a semisynthetic bile acid, is a selective and potent farnesoid X receptor (FXR) agonist in development for the treatment of chronic nonviral liver diseases. Physiologic pharmacokinetic models have been previously used to describe the absorption, distribution, metabolism, and excretion (ADME) of bile acids. OCA plasma levels were measured in healthy volunteers and cirrhotic subjects. A physiologic pharmacokinetic model was developed to quantitatively describe the ADME of OCA in patients with and without hepatic impairment...
October 15, 2016: Clinical and Translational Science
Kendall R Beck, Nicole Kim, Mandana Khalili
BACKGROUND: Vulnerable populations are disproportionately affected by hepatitis C virus (HCV) infection and experience high rates of health disparity. There are no data on real-world experience with highly efficacious direct-acting anti-HCV treatment in this population. AIMS: We aimed to evaluate the real-world experience with sofosbuvir-based regimens among a vulnerable HCV-infected population. METHODS: HCV treatment response was assessed among 204 patients who completed 12-24 weeks of sofosbuvir-based regimens (in combination with pegylated interferon and ribavirin, simeprevir, ledipasvir, or daclatasvir) at the San Francisco safety-net healthcare system liver specialty clinic between January 2014 and December 2015...
October 14, 2016: Digestive Diseases and Sciences
L Benítez-Gutiérrez, C de Mendoza, I Baños, A Duca, A Arias, A Treviño, S Requena, M J Citores, V Cuervas-Mons
New direct-acting antivirals (DAAs) have dramatically improved sustained virologic response (SVR) rates in patients treated for chronic hepatitis C. Although the safety of these agents has been very good in registration trials, unexpected side effects have been reported after much broader use of DAAs on marketing. We retrospectively examined all liver transplant recipients with chronic hepatitis C that received sofosbuvir-based regimens at our clinic. A total of 24 liver transplant recipients with recurrent chronic hepatitis C had received sofosbuvir up to April 2015...
September 2016: Transplantation Proceedings
S Pereira, C M Cruz, M Soares, J Gandara, S Ferreira, V Lopes, R Vizcaíno, J Daniel, H P Miranda
INTRODUCTION: In liver transplantation, late graft dysfunction can have several causes, particularly rejection, infection, vascular, biliary complications, and others, usually suspected by abnormal liver tests. However, normal liver tests do not confirm a normal graft and liver biopsy could identify unexpected features with repercussions in immunosuppressive therapy. The aim of this study was to determinate the histological abnormalities in patients 10 years after liver allograft transplantation with sustainably normal liver tests and evaluate the changes in immunosuppressive therapy triggered by histological data...
September 2016: Transplantation Proceedings
Simonetta Bandiera, C Billie Bian, Yujin Hoshida, Thomas F Baumert, Mirjam B Zeisel
Hepatitis C virus (HCV) infection is one of the major causes of advanced liver disease and hepatocellular carcinoma (HCC) worldwide. While the knowledge about the molecular virology of HCV infection has markedly advanced, the molecular mechanisms of disease progression leading to fibrosis, cirrhosis and HCC are still unclear. Accumulating experimental and clinical studies indicate that HCV may drive hepatocarcinogenesis directly via its proteins or transcripts, and/or indirectly through induction of chronic liver inflammation...
October 11, 2016: Current Opinion in Virology
Nurdan Tözün, Eser Vardareli
Gastrointestinal (GI) cancers are the leading cause of mortality worldwide. These cancers are the end result of a complex interplay between gene and environment. Bacteria, parasites, and viruses have been implicated in some cancers. Recent data have put at focus the gut microbiome as the key player firing tumorigenesis. Experimental and human studies have provided evidence on the role of microbiota in cancer development. Although subject to changes in different settings such as antibiotic treatment, diet or lifestyle, our microbiome is quite stable and is capable of increasing susceptibility to cancer or decrease and halt its progression...
November 2016: Journal of Clinical Gastroenterology
Zobair M Younossi, Haesuk Park, Douglas Dieterich, Sammy Saab, Aijaz Ahmed, Stuart C Gordon
BACKGROUND: New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. AIM: The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. DESIGN: A decision-analytic Markov model...
October 2016: Medicine (Baltimore)
Evelyn Stelzl, Hannah M Appel, Rochak Mehta, Ed G Marins, Jörg Berg, Christian Paar, Hanna Zurl, Brigitte I Santner, Harald H Kessler
BACKGROUND: Determination of the hepatitis C virus (HCV) genotype and discrimination between HCV subtypes 1a and 1b is still mandatory prior to anti-HCV treatment initiation. The aim of this study was to evaluate the performance of the recently introduced cobas® HCV GT assay (Roche) and to compare it to two comparator assays. METHODS: The cobas® HCV GT assay is based on primer-specific real-time polymerase chain reaction (PCR). For comparison, the TRUGENE® HCV 5'NC Genotyping Kit (Siemens) and the VERSANT® HCV Genotype 2...
October 14, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
Maria Stepanova, Trevor Locklear, Nila Rafiq, Alita Mishra, Chapy Venkatesan, Zobair M Younossi
BACKGROUND: Chronic HCV infection is often considered a contraindication for receiving a heart transplantation. METHODS: From the Scientific Registry of Transplant Recipients, we selected all adults with and without HCV infection who underwent a single organ heart transplantation in 1995-2013; the mortality status was updated in September 2015. RESULTS: A total of 32,812 heart transplant recipients were included; N=756 (2.30%) HCV-positive...
October 14, 2016: Clinical Transplantation
Christoph Sarrazin, Vasily Isakov, Evguenia Svarovskaia, Charlotte Hedskog, Ross Martin, Krishna Chodavarapu, Diana M Brainard, Michael D Miller, Hongmei Mo, Jean-Michel Molina, Mark S Sulkowski
BACKGROUND:  Development of direct-acting antivirals in recent years has dramatically enhanced rates of viral eradication to >90% in patients with chronic hepatitis C virus (HCV) infection. To determine true treatment efficacy and to define the most appropriate retreatment, it is important to distinguish virologic relapse from reinfection where patients who achieve HCV eradication during treatment become infected with a new HCV strain posttreatment. METHODS:  Here, we investigated prevalence of late recurrent viremia (patients who achieved SVR12 but had detectable HCV RNA at follow up week 24) and used refined phylogenetic analysis of multiple HCV genes to distinguish virologic relapse from reinfection...
October 12, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Maryam Keshvari, Seyed Moayed Alavian, Bita Behnava, Ali Pouryasin, Johanna C Craig, Heidar Sharafi
BACKGROUND: The aim of this study was to determine whether two polymorphisms of the human interferon lambda 4 (IFNL4) gene (rs12979860 and rs8099917) can predict sustained virologic response (SVR) following antiviral therapy in patients with inherited bleeding disorder and chronic hepatitis C (CHC). METHODS: This retrospective study was conducted on 294 patients with congenital bleeding disorder and CHC who were treated with Peg-Interferon-α (PegIFN) and Ribavirin (RBV)...
October 13, 2016: Journal of Clinical Laboratory Analysis
J Zhou, W-Y Hu, Y-C Li, H-X Luo, J Li, C-H Li, J-J Tong, C-J Chen, L-L Zhang
OBJECTIVE: We conducted a comparison of the diagnostic kit for quantification of hepatitis B virus DNA (PCR-fluorescence probing) and COBAS TaqMan automated nucleic acid extraction and real-time polymerase chain reaction (PCR) amplification systems. We tested their capacity to quantify and diagnose patients with chronic viral hepatitis B with low viral load < 1 x 103 IU/mL, in hope to provide further evidence for promoting the application of COBAS TaqMan as the diagnostic method for such patients...
September 2016: European Review for Medical and Pharmacological Sciences
A G Spruijt, K R Wilting, G D Mithoe, W J M Niessen
OBJECTIVE: To investigate the effect of an intervention in which medical-microbiological laboratories alert general practitioners (GPs) in writing about patients with a chronic hepatitis B or C infection in their practice, urging them to bring these patients under medical surveillance again now that treatment options have improved and guidelines have been revised. DESIGN: Descriptive, prospective. METHOD: All patients who had been diagnosed with hepatitis B or C between 2003 and 2013 on the request of the GP, and for whom diagnostics by an internist, infectious diseases specialist or gastrointestinal/liver specialist had never been requested, were included...
2016: Nederlands Tijdschrift Voor Geneeskunde
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