Chronic Hepatitis C Treatment with Direct-Acting Antiviral Agents in a Real-Life Setting.
BACKGROUND
In clinical trials, new oral direct-acting antiviral agent therapies have demonstrated a high sustained virological response rate in patients with hepatitis C virus infection. We aimed to analyze the efficacy and safety data from direct-acting antiviral agent interferon-free therapy in hepatitis C virus infection in a study performed in five different clinical settings in Mexico City; four private practice sites and one academic medical center in a real-world scenario.


METHODS
Eighty-one patients were treated with seven different direct-acting antiviral agent regimens, in which the end of treatment, sustained virological response at 12 weeks post-treatment, and adverse effects were evaluated. At their discretion, attending physicians selected the treatment regimens and durations.


RESULTS
In total, 70.4% of the patients were female and the mean age was 60.7 years; 74.1% had blood transfusion as a risk factor. The most common genotype was 1b (70.4%). The fibrosis stage was F3 or F4 in 55.5% of patients; liver cirrhosis was present in 44%. The overall end of treatment response was 98.8%, and the rate of sustained virological response was 96%, independent of the regimen. Three patients did not achieve sustained virological response; they had cirrhosis and were treatment-experienced, and two had hepatocarcinoma. Non-significant adverse effects during treatment were documented.


CONCLUSIONS
In this real-life setting in Mexico, a rate of 96% of sustained virological response to direct-acting antiviral agents was achieved in an older population of patients with advanced fibrosis. This study provides data that may be useful in guiding health professionals and authorities in the development of health policies.
Hospital Ángeles Pedregal, Mexico City, Mexico.
Ruby Ann
RA
Chirino-Sprung
Fundación Mexicana para la Salud Hepática, Mexico City, Mexico.
Margarita
M
Dehesa
Clínica Lomas Altas, Mexico City, Mexico.
Enrique
E
Wolpert
Laboratorio Biomédica de Referencia, Mexico City, Mexico.
Clara
C
Corona-Lau
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Ignacio
I
García-Juarez
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
José Francisco
JF
Sánchez-Ávila
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Carlos
C
Moctezuma-Velázquez
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
David
D
Kershenobich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D065227:Transfusion Reaction
D000998:Antiviral Agents