Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655 |
Resumo: | Introduction: In late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection.Material and Methods: A retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program.Results: During the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss.Discussion: Patients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients’ ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data.Conclusion: Our data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting. |
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Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis CExperiência de um Centro Português: Eficácia dos Antivirais de Acção Directa no Tratamento da Hepatite CAntiviral Agents/therapeutic useHepacivirus/drug effectsHepatitis C/drug therapyPortugalAntivirais/uso terapêutticoHepatite C Crónica/tratamentoPortugalVírus da Hepatite C/efeitos dos fármacosIntroduction: In late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection.Material and Methods: A retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program.Results: During the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss.Discussion: Patients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients’ ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data.Conclusion: Our data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting.Introdução: No final de 2014 foi implementado em Portugal um programa nacional para o tratamento de doentes com infecção crónica por vírus da hepatite C com recurso a antivíricos de acção directa. Este programa fez com que Portugal fosse um dos primeiros países europeus a implementar uma medida estruturante para a eliminação da hepatite C. Este estudo tem como objectivo a avaliação da efectividade dos antivíricos de acção directa no tratamento da hepatite C crónica.Material e Métodos: Estudo retrospectivo observacional dos doentes seguidos no Centro Hospitalar de Lisboa Ocidental, entre dezembro de 2014 e fevereiro de 2017. O objectivo primário do estudo é avaliar a resposta virológica sustentada a partir das 12 semanas pós tratamento. Analisámos os dados com o programa SPSS 17.0.Resultados: Durante o período do estudo 820 doentes completaram o tratamento e o tempo necessário para avaliação da resposta virológica sustentada. A resposta virológica sustentada global foi de 97.2% (n = 797), com taxas de resposta de 97,2%, 98,5%, 90,9%, 95,1% e 94,2% para os genótipos 1a, 1b, 2, 3 e 4, respectivamente. Os dados sugerem não haver relação entre a fibrose avançada (F3 / F4), a coinfecção pelo vírus da imunodeficiência humana e a falência do tratamento com interferão e ribavirina e uma menor resposta ao tratamento. A maioria dos doentes (80,1%) concluiu o tratamento com ledipasvir/sofosbuvir ± ribavirina. Os eventos adversos mais frequentes foram a fadiga e a insónia, seguida de dor de cabeça e perda de peso.Discussão: A população em estudo apresentou maior prevalência de infecção pelo genótipo 1, à semelhança dos restantes países Europeus, contudo a prevalência do genótipo 4 foi superior, reflectindo a imigração africana. A faixa etária (22 - 90 anos) dos doentes tratados reflecte uma nova abordagem sem limite superior de idade. A taxa de RVS obtida, muito superior à obtida com regimes baseados em interferão, foi consistente com os dados dos ensaios clínicos.Conclusão: Os dados encontrados demonstram que os regimes baseados em antivirais de acção directa, em contexto de vida real, são seguros e eficazes no tratamento de doentes com infecção por vírus da hepatite C.Ordem dos Médicos2019-03-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfimage/pngimage/pngapplication/mswordapplication/mswordapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655oai:ojs.www.actamedicaportuguesa.com:article/10655Acta Médica Portuguesa; Vol. 32 No. 3 (2019): March; 189-194Acta Médica Portuguesa; Vol. 32 N.º 3 (2019): Março; 189-1941646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/5637https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10323https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10324https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10325https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10326https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10349https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10350https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10458https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10774Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessFalcão, FátimaLopes, CarlaViegas, EricaPerez, RitaAldir, IsabelFarinha, HelenaCarvalho, AntónioMirco, AnaMarques, SusanaBana e Costa, TiagoMiranda, Ana CláudiaLebre, LuísPeixe, PaulaChagas, CristinaMansinho, KamalCorreia, José Manuel2022-12-20T11:06:02Zoai:ojs.www.actamedicaportuguesa.com:article/10655Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:55.245404Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C Experiência de um Centro Português: Eficácia dos Antivirais de Acção Directa no Tratamento da Hepatite C |
title |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
spellingShingle |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C Falcão, Fátima Antiviral Agents/therapeutic use Hepacivirus/drug effects Hepatitis C/drug therapy Portugal Antivirais/uso terapêuttico Hepatite C Crónica/tratamento Portugal Vírus da Hepatite C/efeitos dos fármacos |
title_short |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
title_full |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
title_fullStr |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
title_full_unstemmed |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
title_sort |
Experience of a Portuguese Center: Effectiveness of Direct-Acting Antiviral Therapy for Hepatitis C |
author |
Falcão, Fátima |
author_facet |
Falcão, Fátima Lopes, Carla Viegas, Erica Perez, Rita Aldir, Isabel Farinha, Helena Carvalho, António Mirco, Ana Marques, Susana Bana e Costa, Tiago Miranda, Ana Cláudia Lebre, Luís Peixe, Paula Chagas, Cristina Mansinho, Kamal Correia, José Manuel |
author_role |
author |
author2 |
Lopes, Carla Viegas, Erica Perez, Rita Aldir, Isabel Farinha, Helena Carvalho, António Mirco, Ana Marques, Susana Bana e Costa, Tiago Miranda, Ana Cláudia Lebre, Luís Peixe, Paula Chagas, Cristina Mansinho, Kamal Correia, José Manuel |
author2_role |
author author author author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Falcão, Fátima Lopes, Carla Viegas, Erica Perez, Rita Aldir, Isabel Farinha, Helena Carvalho, António Mirco, Ana Marques, Susana Bana e Costa, Tiago Miranda, Ana Cláudia Lebre, Luís Peixe, Paula Chagas, Cristina Mansinho, Kamal Correia, José Manuel |
dc.subject.por.fl_str_mv |
Antiviral Agents/therapeutic use Hepacivirus/drug effects Hepatitis C/drug therapy Portugal Antivirais/uso terapêuttico Hepatite C Crónica/tratamento Portugal Vírus da Hepatite C/efeitos dos fármacos |
topic |
Antiviral Agents/therapeutic use Hepacivirus/drug effects Hepatitis C/drug therapy Portugal Antivirais/uso terapêuttico Hepatite C Crónica/tratamento Portugal Vírus da Hepatite C/efeitos dos fármacos |
description |
Introduction: In late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection.Material and Methods: A retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program.Results: During the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss.Discussion: Patients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients’ ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data.Conclusion: Our data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-03-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655 oai:ojs.www.actamedicaportuguesa.com:article/10655 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655 |
identifier_str_mv |
oai:ojs.www.actamedicaportuguesa.com:article/10655 |
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eng |
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eng |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/5637 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10323 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10324 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10325 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10326 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10349 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10350 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10458 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10655/10774 |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2019 Acta Médica Portuguesa |
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Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 32 No. 3 (2019): March; 189-194 Acta Médica Portuguesa; Vol. 32 N.º 3 (2019): Março; 189-194 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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