Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy
Background and Aim. The development of interferon- (IFN-) free regimens substantially improved efficacy of treatment for HCV, but despite excellent effectiveness the failures still occur. The aim of our study was to evaluate the efficacy of retreatment with genotype specific direct acting antivirals...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/4029541 |
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| author | Dorota Zarębska-Michaluk Iwona Buczyńska Krzysztof Simon Magdalena Tudrujek-Zdunek Ewa Janczewska Dorota Dybowska Marek Sitko Beata Dobracka Jerzy Jaroszewicz Paweł Pabjan Jakub Klapaczyński Łukasz Laurans Włodzimierz Mazur Łukasz Socha Olga Tronina Miłosz Parczewski Robert Flisiak |
| author_facet | Dorota Zarębska-Michaluk Iwona Buczyńska Krzysztof Simon Magdalena Tudrujek-Zdunek Ewa Janczewska Dorota Dybowska Marek Sitko Beata Dobracka Jerzy Jaroszewicz Paweł Pabjan Jakub Klapaczyński Łukasz Laurans Włodzimierz Mazur Łukasz Socha Olga Tronina Miłosz Parczewski Robert Flisiak |
| author_sort | Dorota Zarębska-Michaluk |
| collection | DOAJ |
| description | Background and Aim. The development of interferon- (IFN-) free regimens substantially improved efficacy of treatment for HCV, but despite excellent effectiveness the failures still occur. The aim of our study was to evaluate the efficacy of retreatment with genotype specific direct acting antivirals- (DAA-) based regimens in nonresponders to previous IFN-free therapy. Materials and Methods. Analysed population consisted of 31 nonresponders to IFN-free regimen, which received second IFN-free rescue therapy, selected from 6228 patients included in a national database EpiTer-2. Results. Age and gender distribution were similar, whereas proportion of genotype 1b was slightly higher and genotype 4 lower in the whole population compared to studied one. Patients included in the study demonstrated much more advanced fibrosis. Primary therapy was discontinued in 12 patients, which were recognized as failures due to nonvirologic reason, whereas virologic reason of therapeutic failure was recognized in 19 patients which completed therapy. Overall sustained virologic response (SVR) rate was 81% and 86% in intent-to-treat (ITT) and modified ITT analysis, respectively (74% and 78% in virologic failures, 92% and 100% in nonvirologic failures). Resistance-associated substitutions (RAS) testing was carried out in 8 patients from the group of completed primary therapy and three of them had potential risk for failure of rescue therapy due to NS5A association, while two of them achieved SVR. Conclusions. We demonstrated moderate effectiveness of genotype specific rescue therapy in failures due to virologic reason and high in those who discontinued primary therapy. Therefore rescue therapy with genotype specific regimens should be considered always if more potent regimens are not available. |
| format | Article |
| id | doaj-art-f0b4cc9cd55c42378960d4bcea26b40e |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-f0b4cc9cd55c42378960d4bcea26b40e2025-02-03T01:24:11ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/40295414029541Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free TherapyDorota Zarębska-Michaluk0Iwona Buczyńska1Krzysztof Simon2Magdalena Tudrujek-Zdunek3Ewa Janczewska4Dorota Dybowska5Marek Sitko6Beata Dobracka7Jerzy Jaroszewicz8Paweł Pabjan9Jakub Klapaczyński10Łukasz Laurans11Włodzimierz Mazur12Łukasz Socha13Olga Tronina14Miłosz Parczewski15Robert Flisiak16Department of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University, Kielce, PolandDepartment of Infectious Diseases and Hepatology, Wrocław Medical University, Wrocław, PolandDepartment of Infectious Diseases and Hepatology, Wrocław Medical University, Wrocław, PolandDepartment of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, PolandDepartment of Basic Medical Sciences, School of Public Health in Bytom, Medical University of Silesia, Katowice, PolandDepartment of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, PolandDepartment of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum, Kraków, PolandMED-FIX Medical Center, Wrocław, PolandDepartment of Infectious Diseases, Medical University of Silesia in Katowice, Bytom, PolandDepartment of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University, Kielce, PolandDepartment of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, PolandMultidisciplinary Regional Hospital in Gorzów Wielkopolski, Gorzów Wielkopolski, PolandClinical Department of Infectious Diseases, Specialist Hospital in Chorzów, Medical University of Silesia, Katowice, PolandDepartment of Infectious Diseases, Hepatology, and Liver Transplantation, Pomeranian Medical University, Szczecin, PolandDepartment of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw, Warsaw, PolandDepartment of Infectious, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, PolandDepartment of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, PolandBackground and Aim. The development of interferon- (IFN-) free regimens substantially improved efficacy of treatment for HCV, but despite excellent effectiveness the failures still occur. The aim of our study was to evaluate the efficacy of retreatment with genotype specific direct acting antivirals- (DAA-) based regimens in nonresponders to previous IFN-free therapy. Materials and Methods. Analysed population consisted of 31 nonresponders to IFN-free regimen, which received second IFN-free rescue therapy, selected from 6228 patients included in a national database EpiTer-2. Results. Age and gender distribution were similar, whereas proportion of genotype 1b was slightly higher and genotype 4 lower in the whole population compared to studied one. Patients included in the study demonstrated much more advanced fibrosis. Primary therapy was discontinued in 12 patients, which were recognized as failures due to nonvirologic reason, whereas virologic reason of therapeutic failure was recognized in 19 patients which completed therapy. Overall sustained virologic response (SVR) rate was 81% and 86% in intent-to-treat (ITT) and modified ITT analysis, respectively (74% and 78% in virologic failures, 92% and 100% in nonvirologic failures). Resistance-associated substitutions (RAS) testing was carried out in 8 patients from the group of completed primary therapy and three of them had potential risk for failure of rescue therapy due to NS5A association, while two of them achieved SVR. Conclusions. We demonstrated moderate effectiveness of genotype specific rescue therapy in failures due to virologic reason and high in those who discontinued primary therapy. Therefore rescue therapy with genotype specific regimens should be considered always if more potent regimens are not available.http://dx.doi.org/10.1155/2019/4029541 |
| spellingShingle | Dorota Zarębska-Michaluk Iwona Buczyńska Krzysztof Simon Magdalena Tudrujek-Zdunek Ewa Janczewska Dorota Dybowska Marek Sitko Beata Dobracka Jerzy Jaroszewicz Paweł Pabjan Jakub Klapaczyński Łukasz Laurans Włodzimierz Mazur Łukasz Socha Olga Tronina Miłosz Parczewski Robert Flisiak Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy Canadian Journal of Gastroenterology and Hepatology |
| title | Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy |
| title_full | Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy |
| title_fullStr | Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy |
| title_full_unstemmed | Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy |
| title_short | Real World Experience of Chronic Hepatitis C Retreatment with Genotype Specific Regimens in Nonresponders to Previous Interferon-Free Therapy |
| title_sort | real world experience of chronic hepatitis c retreatment with genotype specific regimens in nonresponders to previous interferon free therapy |
| url | http://dx.doi.org/10.1155/2019/4029541 |
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