RESUMO
This study aims to identify the predictors of ineffectiveness in antiviral therapy for chronic hepatitis C (CHC) in Kazakhstan. The rising prevalence and mortality rates associated with CHC globally and within Kazakhstan underscore the need for effective antiviral treatment strategies. Despite the introduction of direct-acting antiviral agents (DAAs) with high cure rates, a subset of patients fails to achieve a sustained virological response (SVR). We conducted a multicenter retrospective matched case-control study across 13 regions of Kazakhstan, including 812 patients with CHC. The study involved patients registered in healthcare organizations who had received DAAs, focusing on those who did not reach SVR. Variables such as demographic characteristics, virological status, stage of liver disease, comorbidities, lifestyle factors, therapy regimen, and patient adherence were analyzed. Logistic regression analysis identified multiple factors associated with increased risk of non-response to therapy, including comorbid conditions like arterial hypertension, hepatocellular carcinoma, and lifestyle factors. The study highlights the complexity of CHC treatment in Kazakhstan, emphasizing the need for personalized treatment plans and addressing comorbid conditions and lifestyle factors. This research contributes to understanding the multifaceted nature of CHC treatment response and aids in optimizing therapeutic strategies in similar healthcare settings.
Assuntos
Antivirais , Hepatite C Crônica , Humanos , Cazaquistão/epidemiologia , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Antivirais/uso terapêutico , Masculino , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Adulto , Estudos Retrospectivos , Idoso , Fatores de Risco , Resposta Viral Sustentada , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/epidemiologia , Comorbidade , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/virologiaRESUMO
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.