Results of interferon-free treatment for HCV-infected patients with decompensated cirrhosis from a Brazilian real-life cohort.
Aged
Antiviral Agents
/ adverse effects
Brazil
/ epidemiology
Female
Hepatitis C
/ drug therapy
Humans
Interferons
/ therapeutic use
Liver Cirrhosis
/ drug therapy
Male
Middle Aged
Prospective Studies
Ribavirin
/ therapeutic use
Sofosbuvir
/ adverse effects
Sustained Virologic Response
Treatment Outcome
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
02 Sep 2022
02 Sep 2022
Historique:
entrez:
15
9
2022
pubmed:
16
9
2022
medline:
20
9
2022
Statut:
ppublish
Résumé
Real-life data on the HCV treatment with direct-acting agents in patients with decompensated cirrhosis are scarce. Study to investigate the effectiveness and safety of sofosbuvir-containing regimens in a prospective cohort of patients with HCV decompensated cirrhosis. A total of 150 patients were enrolled (64% male, 84% genotype 1 with a mean age of 61 ± 9 years). The median MELD was 12, and 79% were Child-PughB. Most patients were treated with sofosbuvir and daclatasvir (98%) with ribavirin in 27%. The overall intention to treat SVR12 was 91% (137/150). The most frequent adverse event was anemia (17%), 73% associated with ribavirin. Twenty-one (14%) patients experienced renal dysfunction, 81% AKI I, and 1 discontinued treatment. Thirty-five (23%) patients presented at least 1 infectious episode, mainly respiratory tract infection (29%). Thirty-three patients (22%) had at least 1 episode of cirrhosis decompensation throughout treatment, particularly worsening of previous ascites in 19%. Nine patients died, and among those, 7 patients died from sepsis. The probability of decompensation in 28, 90 and 180 days was 4%, 19% and 25%. During treatment, infection (OR 2.24; 95 CI 1.09-4.61; P = .03) was a predictor of cirrhosis decompensation, and baseline MELD and CHILD ≥ B8 were both associated with infection. In decompensated cirrhosis, the overall virological response was high with mild adverse events. However, this population had a high frequency of liver-associated decompensation and infections.
Identifiants
pubmed: 36107613
doi: 10.1097/MD.0000000000030097
pii: 00005792-202209020-00057
pmc: PMC9439829
doi:
Substances chimiques
Antiviral Agents
0
Ribavirin
49717AWG6K
Interferons
9008-11-1
Sofosbuvir
WJ6CA3ZU8B
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e30097Informations de copyright
Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflict of interest to disclose related to this topic.
Références
Aliment Pharmacol Ther. 2018 Feb;47(3):401-411
pubmed: 29205432
J Med Virol. 2017 Sep;89(9):1590-1596
pubmed: 28370222
Int J Clin Pharm. 2017 Dec;39(6):1304-1311
pubmed: 29079938
J Viral Hepat. 2019 Oct;26(10):1200-1209
pubmed: 31141239
Ann Hepatol. 2019 Nov - Dec;18(6):849-854
pubmed: 31537509
Br J Surg. 1973 Aug;60(8):646-9
pubmed: 4541913
J Hepatol. 2005 Feb;42(2):195-201
pubmed: 15664244
Liver Transpl. 2016 Mar;22(3):281-6
pubmed: 26335142
J Viral Hepat. 2017 Apr;24(4):287-294
pubmed: 27878906
Antivir Ther. 2013;18(3 Pt B):435-44
pubmed: 23792792
Lancet Infect Dis. 2016 Jun;16(6):685-697
pubmed: 26907736
Am J Gastroenterol. 2015 Aug;110(8):1179-85
pubmed: 26215530
Hepatol Int. 2018 Feb;12(Suppl 1):34-43
pubmed: 28681347
Hepatology. 2001 Feb;33(2):464-70
pubmed: 11172350
Transplant Proc. 2018 Apr;50(3):769-771
pubmed: 29661434
Hepatology. 2016 May;63(5):1493-505
pubmed: 26754432
Infect Disord Drug Targets. 2021;21(5):e270421186971
pubmed: 33076813
J Hepatol. 2013 Sep;59(3):434-41
pubmed: 23669289
BMC Infect Dis. 2022 Jan 27;22(1):94
pubmed: 35086481
Lancet Gastroenterol Hepatol. 2016 Oct;1(2):122-132
pubmed: 28404069
Hepatol Int. 2019 Jan;13(1):66-74
pubmed: 30523552
J Clin Exp Hepatol. 2019 Jan-Feb;9(1):4-12
pubmed: 30765933
J Hepatol. 2006 Jan;44(1):217-31
pubmed: 16298014
J Clin Exp Hepatol. 2018 Sep;8(3):241-249
pubmed: 30302040
J Hepatol. 2016 Jun;64(6):1224-31
pubmed: 26829205
J Hepatol. 2014 Nov;61(1 Suppl):S58-68
pubmed: 25443346
Infect Disord Drug Targets. 2020;20(2):143-149
pubmed: 30663575
Expert Opin Investig Drugs. 2016 Oct;25(10):1209-14
pubmed: 27537604
Hepatology. 2005 Mar;41(3):422-33
pubmed: 15723320
Expert Opin Drug Discov. 2015 Dec;10(12):1363-77
pubmed: 26563720
Expert Opin Investig Drugs. 2016;25(5):557-72
pubmed: 26934419
Gastroenterology. 2010 Oct;139(4):1246-56, 1256.e1-5
pubmed: 20558165
Hepatology. 2015 Sep;62(3):715-25
pubmed: 26033798
Hepatol Res. 2019 Apr;49(4):377-384
pubmed: 30570817
Dig Dis Sci. 2015 Apr;60(4):1031-5
pubmed: 25373453
Infect Agent Cancer. 2017 Sep 13;12:48
pubmed: 28924449
Braz J Infect Dis. 2019 May - Jun;23(3):182-190
pubmed: 31145876
J Infect. 2018 Jun;76(6):536-542
pubmed: 29742470