Περίληψη:
Interferon-based regimens for chronic hepatitis C (CHC) were often deferred in patients with β-thalasaemia major (β-TM) due to poor efficacy and tolerance. Current guidelines recommend direct-acting antivirals (DAAs) for these patients. The aim of this study was to assess the safety and efficacy of DAAs in patients with β-TM and advanced liver disease due to CHC. Patients were recruited from eight liver units in Greece. The stage of liver disease was assessed using transient elastography and/or liver histology. Five regimens were used: sofosbuvir (SOF) + ribavirin (RBV); SOF + simeprevir ± RBV; SOF + daclatasvir ± RBV; ledipasvir/SOF ± RBV and ombitasvir/paritaprevir-ritonavir + dasabuvir ± RBV. Sixty-one patients (median age 43 years) were included. The majority of patients was previously treated for hepatitis C (75%) and had cirrhosis (79%). Viral genotype distribution was: G1a: n = 10 (16%); G1b: n = 22 (36%); G2: n = 2 (3%); G3: n = 14 (23%); G4: n = 13 (22%). The predominant chelation therapy was a combination of deferoxamine and deferiprone (35%). Overall sustained virological response rates were 90%. All treatment regimens were well tolerated and no major adverse events or drug-drug interactions were observed. Approximately half of the patients who received RBV (7/16, 44%) had increased needs for blood transfusion. Treatment of CHC with DAAs in patients with β-TM and advanced liver disease was highly effective and safe. © 2017 John Wiley & Sons Ltd
Συγγραφείς:
Sinakos, E.
Kountouras, D.
Koskinas, J.
Zachou, K.
Karatapanis, S.
Triantos, C.
Vassiliadis, T.
Goulis, I.
Kourakli, A.
Vlachaki, E.
Toli, B.
Tampaki, M.
Arvaniti, P.
Tsiaoussis, G.
Bellou, A.
Kattamis, A.
Maragkos, K.
Petropoulou, F.
Dalekos, G.N.
Akriviadis, E.
Papatheodoridis, G.V.
Λέξεις-κλειδιά:
daclatasvir; dasabuvir; deferiprone; deferoxamine; ledipasvir plus sofosbuvir; ombitasvir plus paritaprevir plus ritonavir; ribavirin; simeprevir; sofosbuvir; antivirus agent; BMS-790052; imidazole derivative; ribavirin; simeprevir; sofosbuvir, adult; antiviral therapy; Article; blood transfusion; chelation therapy; chronic hepatitis C; clinical article; combination drug therapy; drug efficacy; drug safety; drug tolerability; female; Hepatitis C virus genotype 1; Hepatitis C virus genotype 2; Hepatitis C virus genotype 3; Hepatitis C virus genotype 4; human; liver cirrhosis; male; middle aged; priority journal; thalassemia major; beta thalassemia; chronic hepatitis C; clinical trial; complication; genetics; genotype; Hepacivirus; isolation and purification; liver cirrhosis; multicenter study; severity of illness index; virology, Adult; Antiviral Agents; beta-Thalassemia; Drug Therapy, Combination; Female; Genotype; Hepacivirus; Hepatitis C, Chronic; Humans; Imidazoles; Liver Cirrhosis; Male; Middle Aged; Ribavirin; Severity of Illness Index; Simeprevir; Sofosbuvir
