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Oral ribavirin

Jeremy Woodward, Effrossyni Gkrania-Klotsas, Dinakantha Kumararatne
Chronic infection with Norovirus is emerging as a significant risk for patients with immunodeficiency - either primary or secondary to therapeutic immunosuppression. Patients with primary immunodeficiency present a range of pathological responses to Norovirus infection. Asymptomatic infections occur and differentiating viral carriage or prolonged viral shedding after self-limiting infection from infection causing protracted diarrhoea can be challenging due to relatively mild pathological changes that may mimic other causes of diarrhoea in such patients (for instance pathogenic bacteria or parasites or graft-versus-host disease)...
October 18, 2016: Clinical and Experimental Immunology
Yu Mi Seo, Seok Hwang-Bo, Seong Koo Kim, Seung Beom Han, Nack-Gyun Chung, Jin Han Kang
BACKGROUND: Although adenovirus (ADV) infection usually causes self-limiting respiratory disorders in immune competent children; severe and systemic ADV infection in children undergoing chemotherapy for leukemia has been continuously reported. Nevertheless, there has been no consensus on risk factors and treatment strategies for severe ADV infection in children undergoing chemotherapy. CASE SUMMARY: We report a case of a 15-year-old boy with a fatal systemic ADV infection...
October 2016: Medicine (Baltimore)
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
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)
Maribel Rodriguez-Torres, Eric Lawitz, Bienvenido Yangco, Lennox Jeffers, Steven-Huy Han, Paul J Thuluvath, Vinod Rustgi, Stephen Harrison, Reem Ghalib, John M Vierling, Velimir Luketic, Philippe J Zamor, Natarajan Ravendhran, Timothy R Morgan, Brian Pearlman, Christopher O'Brien, Hicham Khallafi, Nikolaos Pyrsopoulos, George Kong, Fiona McPhee, Philip D Yin, Eric Hughes, Michelle Treitel
:  Background. Patient race and ethnicity have historically impacted HCV treatment response. This phase 3 study evaluated daclatasvir with peginterferon-alfa-2a/ribavirin (pegIFN alfa-2a/RBV) in treatment-naive black/African American (AA), Latino, and white non-Latino patients with chronic HCV genotype 1 infection. MATERIAL AND METHODS: In this single-arm, open-label study, 246 patients received daclatasvir plus pegIFN alfa-2a and weight-based RBV. Patients with an extended rapid virologic response (eRVR; undetectable HCV-RNA at treatment weeks 4 and 12) received 24 weeks of treatment; those without eRVR received an additional 24 weeks of treatment with pegIFN alfa-2a/RBV...
November 2016: Annals of Hepatology
Sarah L Greig
A once-daily, single-tablet, pangenotypic regimen comprising the hepatitis C virus (HCV) NS5B polymerase inhibitor sofosbuvir and the HCV NS5A inhibitor velpatasvir (sofosbuvir/velpatasvir; Epclusa(®)) was recently approved for the treatment of adults with chronic HCV genotype 1, 2, 3, 4, 5 or 6 infection in the USA, EU and Canada. In the phase III ASTRAL trials, once-daily oral sofosbuvir/velpatasvir for 12 weeks provided very high rates of sustained virological response at 12 weeks post treatment (SVR12) in treatment-naive and -experienced patients with chronic HCV genotype 1-6 infection, including those with compensated cirrhosis or HIV-1 co-infection...
October 11, 2016: Drugs
Linda Henry, Zobair Younossi
We used published literature from 2013- 2016, to review data regarding the new all oral interferon and ribavirin free direct acting antiviral (DAA's) treatment regimens. Areas covered: Specifically, this paper will address DAA's clinical efficacy, their associated patient reported outcomes, their adherence to treatment, and their cost-effectiveness of treatment using studies from the United States. Expert commentary: The current data suggest that cure and elimination of HCV appears to be on the horizon; however, more research is needed to verify similar results from real world practices...
October 6, 2016: Expert Review of Pharmacoeconomics & Outcomes Research
Norio Akuta, Masahiro Kobayashi, Fumitaka Suzuki, Hitomi Sezaki, Shunichiro Fujiyama, Yusuke Kawamura, Tetsuya Hosaka, Mariko Kobayashi, Satoshi Saitoh, Yoshiyuki Suzuki, Yasuji Arase, Kenji Ikeda, Hiromitsu Kumada
BACKGROUND AND AIMS: Predictive factors for hepatocarcinogenesis following eradication of hepatitis C virus (HCV) RNA by antiviral therapy with direct-acting antivirals are unknown. Especially the impact of treatment with or without interferon on hepatocarcinogenesis is not clear. METHODS: A total of 958 patients with HCV genotype 1-related chronic liver disease and a sustained virological response defined as negative HCV RNA 24 weeks after cessation of antiviral therapy with direct-acting antivirals (triple therapy of NS3/4A protease inhibitor/peginterferon/ribavirin or all-oral combination therapy with NS3/4A protease inhibitor plus NS5A inhibitor) were included in a retrospective study...
October 1, 2016: Oncology
R J Wong, M T Nguyen, H N Trinh, A Huynh, M T Ly, H A Nguyen, K K Nguyen, J Yang, R T Garcia, B Levitt, E da Silveira, R G Gish
Sofosbuvir/ledipasvir (SOF/LDV) is the first all-oral ribavirin-free treatment approved for chronic hepatitis C virus (HCV) genotype 6, offering a safe and highly efficacious treatment option. Large studies evaluating real-world outcomes of this regimen are lacking. We aim to evaluate real-world treatment outcomes for HCV genotype 6. A retrospective cohort study evaluated 65 adults (age ≥18) with chronic HCV genotype 6 treated with SOF/LDV without ribavirin at a community gastroenterology clinic in the United States from November 2014 to May 2016...
September 27, 2016: Journal of Viral Hepatitis
Darius Moradpour, Arash Grakoui, Michael P Manns
With the latest all-oral interferon- and ribavirin-free regimens based on direct acting antivirals against the hepatitis C virus (HCV), sustained virological response rates of >90% are achieved, which is equivalent to cure. This has become possible for all genotypes and all subgroups of patients, including many of the most difficult-to-treat populations so far. Since a prophylactic HCV vaccine is not yet available, control of HCV infection will for the time being have to rely on the use of effective and safe antiviral treatments as well as their accessibility and affordability...
October 2016: Journal of Hepatology
N Raschzok, E Schott, A Reutzel-Selke, I Damrah, S Gül-Klein, B Strücker, I M Sauer, J Pratschke, D Eurich, M Stockmann
BACKGROUND: The new directly acting antivirals (DAAs) enable all-oral interferon-free treatment of chronic hepatitis C virus (HCV) infection. We here investigated the effect of DAAs on the enzymatic liver function of liver transplant recipients with recurrent hepatitis C. METHODS: Twenty-one patients with elevated liver enzymes or advanced fibrosis/compensated cirrhosis due to recurrent HCV were treated with sofosbuvir either in combination with simeprevir, or in combination with ribavirin or daclatasvir with or without ribavirin for 12 weeks...
September 15, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Samson E Isa, Attah Okwute, Kelly O Iraoyah, Shehu Y Nathan, Gomerep S Simji, Mark O Okolo, Joseph Anejo-Okopi, Daria Spicola, Daisy E Isa
BACKGROUND: Secondary transmission of Lassa fever (LF) occurs in the community and in health-care facilities, and is associated with high fatality in Nigeria. We investigated the role of oral ribavirin postexposure prophylaxis (orPEP) in preventing LF among the primary contacts of confirmed cases from December 2015 to March 2016. MATERIALS AND METHODS: Epidemiological and clinical data of LF contacts were prospectively collected. However, information regarding ribavirin adverse effects (AEs) were collected retrospectively through a telephone interview...
July 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Sandeep Satsangi, Manu Mehta, Ajay Duseja, Sunil Taneja, Radha K Dhiman, Yogesh Chawla
INTRODUCTION: Sofosbuvir (SOF) was the first directly acting antiviral (DAA) made available for chronic hepatitis C (CHC) in India. We describe our 'real life' experience of using SOF with ribavirin (RBV) with or without pegylated interferon (PegIFN) in predominant genotype 3 patients with CHC. METHODOLOGY: 158 patients [Males 99 (62.6%), mean age 40.3 ± 12.8 years) with CHC treated with dual therapy (SOF + RBV) for 24 weeks or triple therapy (PegIFN + SOF + RBV) for 12 weeks were included prospectively...
September 14, 2016: Journal of Gastroenterology and Hepatology
Olivier Ethgen, Yuri Sanchez Gonzalez, Grégoire Jeanblanc, Aurore Duguet, Derek Misurski, Timothy Juday
OBJECTIVE: To estimate the public health impact of comprehensive hepatitis C virus (HCV) screening and access to all-oral, interferon (IFN)-free direct-acting antivirals (DAAs) in the French baby-boomer population (1945-1965 birth cohorts). METHODS: A sequential, multi-cohort, health-state transition model was developed to assess the impact of different hepatitis C screening and treatment strategies on clinical and economic outcomes in the 1945-1965 birth cohorts...
September 2, 2016: Journal of Medical Economics
Gillian M Keating
The hepatitis C virus (HCV) NS5A replication complex inhibitor daclatasvir (Daklinza(®)) is indicated for use in combination with sofosbuvir, with or without ribavirin, in a pangenotypic all-oral regimen. In patients with chronic HCV genotype 1 or 3 infection without cirrhosis, a 12-week regimen of daclatasvir plus sofosbuvir achieved high sustained virological response rates 12 weeks' post-treatment (SVR12), regardless of prior treatment experience, according to the results of the AI444040 and ALLY-3 trials...
September 2016: Drugs
N Gamal, P Andreone
Hepatitis C virus (HCV) infection is an increasing public health concern with an estimated 184 million people infected worldwide and approximately 350,000 deaths yearly from HCV-related complications. There is a compelling medical need for new anti-HCV therapeutic agents that are potent, tolerable, safe, completely oral and with shorter treatment duration. To this end, a plethora of direct-acting antivirals have been developed and regulatory authorities have approved nine new molecules for the treatment of chronic hepatitis C (CHC)...
July 2016: Drugs of Today
Masahiro Kobayashi, Fumitaka Suzuki, Shunichiro Fujiyama, Yusuke Kawamura, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Yoshiyuki Suzuki, Satoshi Saitoh, Yasuji Arase, Kenji Ikeda, Hiromitsu Kumada
The aim of this study was to assess the rate of development of hepatocellular carcinoma (HCC) in patients who achieved sustained virologic response (SVR) by direct anti-viral agents (DAA). We retrospectively evaluated patients who achieved SVR by oral DAA interferon-free regimens (n = 77) [daclatasvir/asunaprevir (n = 67), ombitasvir/paritaprevir/ritonavir (n = 9), and telaprevir (n = 1)] and by pegylated-interferon plus ribavirin (Peg-IFN/RBV, n = 528). In all patients, the background was chronic hepatitis or cirrhosis caused by HCV genotype 1b...
August 17, 2016: Journal of Medical Virology
Gil Ben Yakov, Daniela Montano, Naim Abu Freha, Ohad Etzion, Vitaly Dizingof, Alex Mushkalo, Doron Shwarts, Shulamit Monitin, Anna Takchick, Dorin Zilberman, Emanuel Sikuler, Alexander Fich
BACKGROUND: For the last decade the backbone of hepatitis C (HCV) treatment was the pan-genotyping dual therapy with pegylated interferon alfa in combination with Ribavirin. This regimen was limited in achieving sustained virological response (SVR) and accompanied by serious adverse events. In 2010 there was overwhelming progress in the treatment options for HCV. This change began with the introduction of the first generation specific Direct Antiviral Agents (DAA's) that inhibit the viral protease, agents used in combination with the dual protocol for genotype 1 (triple therapy)...
May 2016: Harefuah
Jasmina Simonović Babić, Ksenija Bojović, Dragan Delić, Nataga Katanić, Nikola Mitrović, Jovan Malinić
INTRODUCTION: Seroprevlence of chronic hepatitis C viral infection in correctional facilities ranges from 16% to 49%. However, there are only very limited data available on the course of hepatitis C viral infection and outcomes oftreatment with pegylated interferon plus ribavirin in correctional settings. The aim ofthis study was to assess the feasibility and effectiveness of use of pegylated interferon plus ribavirin treatment in the Serbian correctional setting. MATERIAL AND METHODS: The study sample consisted of the patients with hepatitis C hospitalized in the Special Hospital for Prisoners in Belgrade (Serbia) during 2007-2013...
March 2016: Medicinski Pregled
Pankaj Puri, Vivek A Saraswat, Radha K Dhiman, Anil C Anand, Subrat K Acharya, Shivaram P Singh, Yogesh K Chawla, Deepak N Amarapurkar, Ajay Kumar, Anil Arora, Vinod K Dixit, Abraham Koshy, Ajit Sood, Ajay Duseja, Dharmesh Kapoor, Kaushal Madan, Anshu Srivastava, Ashish Kumar, Manav Wadhawan, Amit Goel, Abhai Verma, Shalimar, Gaurav Pandey, Rohan Malik, Swastik Agrawal
India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy...
June 2016: Journal of Clinical and Experimental Hepatology
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