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Eligibility and safety of the first interferon-free therapy against hepatitis C in a real-world setting
- Source :
- Liver international : official journal of the International Association for the Study of the Liver. 35(7)
- Publication Year :
- 2014
-
Abstract
- Background & Aims Several real world data demonstrated that eligibility for and tolerability of triple therapy against hepatitis C virus (HCV) infection with a first-wave protease inhibitor is limited. With the approval of sofosbuvir (SOF) effective treatment with and without pegylated interferon (PEG-IFN) has become available for most genotypes. However, no data are available regarding the added benefit of an interferon-free treatment concerning eligibility and tolerability in a real-world scenario. We aimed to assess the eligibility and safety of SOF based therapies in patients with primarily advanced cirrhosis, including decompensated cirrhosis, in a real-world setting. Results In total, 207 patients were evaluated for a SOF based treatment with and without PEG-IFN. Twenty-six patients did not receive treatment because of safety reasons. Common causes were severe concomitant cardiac disease and advanced renal disease. Autoimmune disease, thrombopaenia, anaemia or hepatic dysfunction did not preclude treatment. Eighty-four patients started treatment, 15 with decompensated cirrhosis. During the first 12 weeks hospitalization occurred in 11 patients most frequently because of typical complications of advanced liver disease. Risk factors for hospitalization were low platelet count and deteriorated liver function. Overall, 982 of 1008 planned treatment weeks (97%) were successfully completed within the first 12 weeks of therapy. Conclusion With the better safety profile of interferon-free therapies, eligibility for HCV treatment will expand broadly, including patients with decompensated cirrhosis. Current limitations are renal failure and concomitant cardiac disease. Patients with advanced cirrhosis still have a high risk for hospitalization even with interferon-free therapies, but can continue HCV treatment in most cases.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Sofosbuvir
Genotype
Hepatitis C virus
Eligibility Determination
Hepacivirus
medicine.disease_cause
Antiviral Agents
Polyethylene Glycols
Liver disease
Pegylated interferon
Risk Factors
Internal medicine
Ribavirin
medicine
Humans
Prospective Studies
Aged
Hepatology
business.industry
Patient Selection
Interferon-alpha
Hepatitis C
Hepatitis C, Chronic
Middle Aged
medicine.disease
Surgery
Hospitalization
Treatment Outcome
Tolerability
Concomitant
Drug Therapy, Combination
Female
Liver function
business
medicine.drug
Subjects
Details
- ISSN :
- 14783231
- Volume :
- 35
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Accession number :
- edsair.doi.dedup.....d6d1fb873efe7ad7adef6307ad0fb352