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DAAs in Genotypes 1 and 4 of Chronic Hepatitis C—A Real World Experience
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
DAAS IN GENOTYPES 1 AND 4 OF CHRONIC HEPATITIS C—A REAL WORLD EXPERIENCE Sukanya Brugu, Bubun Patel, Nayana Joshi, Raghavendra Yarlagadda, Rohit Maidur, Gaurav Ratnaparkhi, Ajit Kumar Nizam’s Institute of Medical Sciences, Hyderabad, India
Background and Aim: HCV infection is a major cause of liver disease throughout the world with global prevalence of 3%. In India, Hepatitis C prevalence is 1% and genotypes 1 and 3 are the common genotypes. Aims and Objective: To determine treatment outcome of DAAs in genotypes 1 and 4 with different regimens. Methods: Prospective study of consecutive chronic hepatitis C (CHC) patients from February 2015, who completed at least 12 weeks of therapy were recruited. Results: 100 consecutive CHC patients were screened. 49, 1, 39, 9 patients were genotype 1, 2, 3, 4 respectively, 2 were not typable. 58 patients (33 M:25 F), mean age 52.5 11.8 were included. Among 58 patients, 49 and 9 were genotypes 1 and 4 respectively. Median baseline viral load was 5.3 105 IU/ml (range: 1.1 103–1 108). 39/58 completed 12 weeks of therapy, 2 were lost to follow up, and 2 did not complete treatment. Overall ETR and SVR rates were 89% and 83.3% in cirrhotics and 93.1% and 94.4% in non-cirrhotics respectively. In genotype-1, overall SVR rate was 95%; ETR and SVR rates were 83.3% and 83.3% in cirrhotics and 100% and100% in non-cirrhotics respectively. In genotype-4, all were non-cirrhotics and ETR and SVR rates were 75% and 75% respectively. In genotypes 1 and 4, ETR and SVR rates were 96% and 95% with triple therapy (n = 27), 75% and 67% with Sofosbuvir + Ribavirin (n = 4), 100% and 100% with Sofosbuvir + Ledipasvir (n = 8). Overall ETR and SVR rates were 93% and 89% in treatment naive and 100% and 100% in treatment experienced respectively. Conclusion: Genotype1 is the most prevalent genotype in South-India. Non-cirrhotics had a better SVR as compared to cirrhotics. Interferon based triple therapy and Interferon free dual DAAs have comparable efficacy. CONFLICTS OF INTEREST The authors have none to declare.
Corresponding author: Sukanya Brugu. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.036
23 DAAS IN GENOTYPES 2 AND 3 OF CHRONIC HEPATITIS C—A REAL WORLD EXPERIENCE Bubun Patel, Sukanya Bhrugu, Raghavendra Yarlagadda, Nayana Joshi, Rohit Maidur, Gaurav Ratnaparkhi, Ajit Kumar Nizam’s Institute of Medical Sciences, Hyderabad, India
Background and Aim: Direct acting antivirals have revolutionised treatment of Hepatitis C with Hepatitis C now being considered curable. However management of genotype 3 remains challenging. Aims and Objective: To determine treatment outcome of DAAs in genotypes 2 and 3 with different regimens. Methods: Consecutive patients of genotype 2 and 3 from February 2015, who completed at least 12 weeks of therapy were included. Results: 40 patients (32 M:8 F), mean age 54.3 9.8 were included. Among 40 patients, 1 and 39 were genotype 2 and 3 respectively. Median baseline viral load was 6.7 105 IU/ml (range: 6.6 103– 7.5 107). 27/40 completed at least 12 weeks of therapy, 2 were lost to follow up, 1 underwent liver transplantation, 1 did not complete treatment, and 3 expired during treatment. Overall ETR and SVR rates were 100% and 66.7% in cirrhotics and 94% and 93% in non-cirrhotics respectively. In genotype3, overall SVR rate was 88%; ETR and SVR rates were 100% and 66.7% in cirrhotics and 94.1% and 93% in noncirrhotics respectively. In genotype-2, ETR was 100%. In genotype 2 and 3, ETR and SVR rates were 91.7% and 89% with PegIFN + Sofosbuvir + Ribavirin (n = 12), 100% and 83.3% with Sofosbuvir + Ribavirin (n = 14), 100% and 100% with Sofosbuvir + Daclatasvir (n = 3). Overall ETR and SVR rates were 95.2% and 87.5% in treatment naive and 100 and 100% in treatment experienced respectively. Conclusion: Genotype 2 is uncommon in our population. In genotype 3, SVR rates in cirrhotics remains low despite use of DAAs. Interferon based triple therapy and dual DAAs have comparable outcomes.
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S8–S22
S19
Viral Hepatitis
22
DAAS IN GENOTYPES 1 AND 4 OF CHRONIC HEPATITIS C—A REAL WORLD EXPERIENCE Sukanya Brugu, Bubun Patel, Nayana Joshi, Raghavendra Yarlagadda, Rohit Maidur, Gaurav Ratnaparkhi, Ajit Kumar Nizam’s Institute of Medical Sciences, Hyderabad, India
Background and Aim: HCV infection is a major cause of liver disease throughout the world with global prevalence of 3%. In India, Hepatitis C prevalence is 1% and genotypes 1 and 3 are the common genotypes. Aims and Objective: To determine treatment outcome of DAAs in genotypes 1 and 4 with different regimens. Methods: Prospective study of consecutive chronic hepatitis C (CHC) patients from February 2015, who completed at least 12 weeks of therapy were recruited. Results: 100 consecutive CHC patients were screened. 49, 1, 39, 9 patients were genotype 1, 2, 3, 4 respectively, 2 were not typable. 58 patients (33 M:25 F), mean age 52.5 11.8 were included. Among 58 patients, 49 and 9 were genotypes 1 and 4 respectively. Median baseline viral load was 5.3 105 IU/ml (range: 1.1 103–1 108). 39/58 completed 12 weeks of therapy, 2 were lost to follow up, and 2 did not complete treatment. Overall ETR and SVR rates were 89% and 83.3% in cirrhotics and 93.1% and 94.4% in non-cirrhotics respectively. In genotype-1, overall SVR rate was 95%; ETR and SVR rates were 83.3% and 83.3% in cirrhotics and 100% and100% in non-cirrhotics respectively. In genotype-4, all were non-cirrhotics and ETR and SVR rates were 75% and 75% respectively. In genotypes 1 and 4, ETR and SVR rates were 96% and 95% with triple therapy (n = 27), 75% and 67% with Sofosbuvir + Ribavirin (n = 4), 100% and 100% with Sofosbuvir + Ledipasvir (n = 8). Overall ETR and SVR rates were 93% and 89% in treatment naive and 100% and 100% in treatment experienced respectively. Conclusion: Genotype1 is the most prevalent genotype in South-India. Non-cirrhotics had a better SVR as compared to cirrhotics. Interferon based triple therapy and Interferon free dual DAAs have comparable efficacy. CONFLICTS OF INTEREST The authors have none to declare.
Corresponding author: Sukanya Brugu. E-mail: [email protected] http://dx.doi.org/10.1016/j.jceh.2016.06.036
23 DAAS IN GENOTYPES 2 AND 3 OF CHRONIC HEPATITIS C—A REAL WORLD EXPERIENCE Bubun Patel, Sukanya Bhrugu, Raghavendra Yarlagadda, Nayana Joshi, Rohit Maidur, Gaurav Ratnaparkhi, Ajit Kumar Nizam’s Institute of Medical Sciences, Hyderabad, India
Background and Aim: Direct acting antivirals have revolutionised treatment of Hepatitis C with Hepatitis C now being considered curable. However management of genotype 3 remains challenging. Aims and Objective: To determine treatment outcome of DAAs in genotypes 2 and 3 with different regimens. Methods: Consecutive patients of genotype 2 and 3 from February 2015, who completed at least 12 weeks of therapy were included. Results: 40 patients (32 M:8 F), mean age 54.3 9.8 were included. Among 40 patients, 1 and 39 were genotype 2 and 3 respectively. Median baseline viral load was 6.7 105 IU/ml (range: 6.6 103– 7.5 107). 27/40 completed at least 12 weeks of therapy, 2 were lost to follow up, 1 underwent liver transplantation, 1 did not complete treatment, and 3 expired during treatment. Overall ETR and SVR rates were 100% and 66.7% in cirrhotics and 94% and 93% in non-cirrhotics respectively. In genotype3, overall SVR rate was 88%; ETR and SVR rates were 100% and 66.7% in cirrhotics and 94.1% and 93% in noncirrhotics respectively. In genotype-2, ETR was 100%. In genotype 2 and 3, ETR and SVR rates were 91.7% and 89% with PegIFN + Sofosbuvir + Ribavirin (n = 12), 100% and 83.3% with Sofosbuvir + Ribavirin (n = 14), 100% and 100% with Sofosbuvir + Daclatasvir (n = 3). Overall ETR and SVR rates were 95.2% and 87.5% in treatment naive and 100 and 100% in treatment experienced respectively. Conclusion: Genotype 2 is uncommon in our population. In genotype 3, SVR rates in cirrhotics remains low despite use of DAAs. Interferon based triple therapy and dual DAAs have comparable outcomes.
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S8–S22
S19
Viral Hepatitis
22