An algorithm for simplified hepatitis C virus treatment with non-specialist care based on nation-wide data from Taiwan.
Hepatol Int
; 18(2): 461-475, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38246899
ABSTRACT
BACKGROUND:
Both European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (AASLD-IDSA) guidelines recommend simplified hepatitis C virus (HCV) treatment with pan-genotypic sofosbuvir/velpatasvir or glecaprevir/pibrentasvir for eligible patients. This observational study used real-world data to assess these regimens' safety in eligible patients and develop an algorithm to identify patients suitable for simplified treatment by non-specialists.METHODS:
7,677 HCV-infected patients from Taiwan Hepatitis C Registry (TACR) who received at least one dose of sofosbuvir/velpatasvir or glecaprevir/pibrentasvir, and fulfilled the EASL/AASLD-IDSA criteria for simplified treatment were analyzed. Multivariate analysis was conducted on patient characteristics and safety data.RESULTS:
Overall, 92.8% (7,128/7,677) of patients achieved sustained virological response and only 1.9% (146/7,677) experienced Grades 2-4 laboratory abnormalities in key liver function parameters (alanine aminotransferase, aspartate aminotransferase, and total bilirubin), with only 18 patients (0.23%) experiencing Grades 3-4 abnormalities. Age > 70 years old, presence of hepatocellular carcinoma, total bilirubin > 1.2 mg/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, and Fibrosis-4 > 3.25 were associated with higher risks of Grades 2-4 abnormalities. Patients with any of these had an odds of 4.53 times than that of those without in developing Grades 2-4 abnormalities (p < 0.01).CONCLUSIONS:
Real-world data from Taiwan confirmed that simplified HCV treatment for eligible patients with pan-genotypic regimens is effective and well tolerated. The TACR algorithm, developed based on this study's results, can further identify patients who can be safely managed by non-specialist care.Palavras-chave
American Association for the Study of Liver Diseases and the Infectious Diseases Society of America; Direct-acting antivirals; European Association for the Study of the Liver; Laboratory abnormalities; Liver function; Safety; Simplified treatment; Taiwan hepatitis C registry; glecaprevir/pibrentasvir; sofosbuvir/velpatasvir
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sulfonamidas
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Benzimidazóis
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Benzopiranos
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Carbamatos
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Prolina
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Hepatite C
/
Hepatite C Crônica
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Ciclopropanos
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Lactamas Macrocíclicas
/
Ácidos Aminoisobutíricos
Tipo de estudo:
Guideline
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Observational_studies
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Prognostic_studies
Limite:
Aged
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Humans
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article