Efficacy of Elbasvir/Grazoprevir in Early Chronic G1/G4 Hepatitis C infection in HIV/HCV co-infected patients with mild fibrosis.
Gastroenterol Hepatol
; 44(3): 191-197, 2021 Mar.
Article
in En, Es
| MEDLINE
| ID: mdl-33041087
ABSTRACT
BACKGROUND:
Acute hepatitis C virus (AHC) infection is increasingly common among HIV+ men who have sex with men (MSM). Until 2017, the guidelines recommended therapy with pegylated-interferon plus ribavirin with a mild sustained virological response (SVR). This prompted many patients to reject that treatment, at that time, waiting to be treated with better and safer options with new Direct-Acting-Antivirals (DAA).OBJECTIVES:
Assess the efficacy and safety of Elbasvir/Grazoprevir to treat recent chronic hepatitis C infection, genotype 1 or 4, in HIV+ MSM patients.METHODS:
Prospective, open-labeled, two center, pilot study. SVR is analyzed for treatment with Elbasvir/Grazoprevir (8 weeks in GT1b or 12 in GT1a or GT4) in patients with a recent chronic HCV infection, defined as HCV infection lasting less than 4 years and mild liver fibrosis (liver stiffness <8kPa).RESULTS:
Forty-eight patients were included (May 2017-March 2018) 2 GT1b, 24 GT1a and 22 GT4. HCV-RNA>800000UI in 63% and medium liver stiffness 4.9kPa. The SVR was 98%, one patient failed due to poor adherence. 67% of patients had adverse effects, but only 16% treatment related. The most frequent side effects were gastrointestinal (19%), related with the central nervous system (18%), respiratory (16%) and systemic symptoms (15%). During one year of follow-up post-therapy, 4 AHC and 18 patients with sexually transmitted diseases (STD) were diagnosed.CONCLUSIONS:
Treatment with Elbasvir/Grazoprevir in this scenario is highly effective and safe. Patients with risky sexual practices must remain linked to the medical care system to detect new STD and HCV reinfection.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Quinoxalines
/
Benzofurans
/
HIV Infections
/
Hepatitis C, Chronic
/
Coinfection
/
Imidazoles
Type of study:
Clinical_trials
/
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
/
Male
/
Middle aged
Language:
En
/
Es
Journal:
Gastroenterol Hepatol
Year:
2021
Type:
Article