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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

VARGAS, José Ignacio et al. Nuevas terapias orales de acción directa para tratamiento de virus de hepatitis C (VHC). Rev. méd. Chile [online]. 2017, vol.145, n.10, pp.1235-1242. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872017001001235.

Background:

The availability of direct-acting antivirals (DAA) for the treatment of chronic hepatitis C virus (HCV) infection is just starting to expand in Chile.

Aim:

To report the initial experience of patients treated with DAA and their evolution after treatment.

Material and Methods:

Prospective cohort study, from June 2013 to August 2016 of patients treated with DAA for HCV in three clinical centers. The presence of cirrhosis, clinical and laboratory features; adverse events (AE) and post-treatment changes in liver function were evaluated. Sustained viral response at 12 weeks post-treatment (SVR12) was determined.

Results:

One hundred six patients aged 58 ± 13 years, 54% males, were included. HCV genotype 1b was present in 88% and 47% had cirrhosis. Treatment regimens were asunaprevir + daclatasvir (DCV) in 17% of patients, paritaprevir / ritonavir / ombitasvir + dasabuvir in 33%, sofosbuvir (SOF) + DCV in 19%, and SOF + ledipasvir in 30%. Twenty five percent of patients used generic drugs. SVR12 was 92.1%, with no differences between generic and brand-name drugs. Serious AE were recorded in 22% of patients, being more common in those with cirrhosis (34% vs 11.5%, p < 0.01). At 12 weeks post-treatment follow-up, there was a decrease in aminotransferase values (p < 0.01), improvement in Child-Pugh score (5.9 vs. 5.5, p = 0.03) and decreased presence of ascites (p = 0.02).

Conclusions:

In our setting, DAA for HCV was highly effective and safe in non-cirrhotic patients. Hepatic function and inflammation improved at 12 weeks of follow-up. AE were common in patients with cirrhosis, suggesting that these patients should be treated by experienced teams. Generic drugs had similar effectiveness compared to originals.

Keywords : Antiviral Agents; Chile; Drugs; Generic; Fibrosis; Hepatitis C; Latin America.

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