Effectiveness, tolerability and safety of Direct Acting Antivirals in Mexican individuals with Hepatitis C virus genotype-1 and previous pegylated interferon and ribavirin therapy

PeerJ

article

Daniel Melendez-Mena¹  Miguel Angel Mendoza-Torres¹  Virginia Sedeño-Monge³  Víctor Hugo García y García²  Elain Rivera-García³  Laura Sánchez-Reza²  María del Carmen Baxin Domínguez⁴  Belinda Guzmán-Flores⁵  Ygnacio Martinez-Laguna⁶  José Manuel Coronel Espinoza⁷  Iván Galindo-Santiago⁸  Juan Carlos Flores-Alonso⁸  Verónica Vallejo-Ruiz⁸  Paulina Cortes-Hernandez⁹  Julio Reyes-Leyva⁸  Francisca Sosa-Jurado⁸  Gerardo Santos-López⁸ 

[1] Centro Interdisciplinario de Posgrados, Facultad de Medicina, Universidad Popular Autonóma del Estado de Puebla;Servicio de Gastroenterología, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social;Decanato de Ciencias Médicas, Universidad Popular Autonóma del Estado de Puebla;Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social;Banco de Sangre, Centro Médico Nacional General de División Manuel Ávila Camacho, Instituto Mexicano del Seguro Social;Instituto de Ciencias, Benemerita Universidad Autónoma de Puebla;Hospital General Regional # 1, Instituto Mexicano del Seguro Social;Laboratorio de Biología Molecular y Virología, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social;Laboratorio de Biología Celular, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social

关键词: Hepatitis C;    Sustained viral response;    Direct acting antivirals;    Child-Pugh-Score;    FIB-4;    APRI index;   

DOI  :  10.7717/peerj.12051

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundDirect Acting Antivirals (DAAs) represent a large improvement in the treatment of chronic hepatitis C, resulting in <90% sustained virological response (SVR). There are no reports on the real-world DAA response for Mexico and few reports exist for Latin America. The aim of the study was to report SVR, and immediate benefits with the DAA treatments sofosbuvir, ledispavir, with/without ribavirin (SOF/LDV ± RBV) and ombitasvir, paritaprevir, ritonavir, dasabuvir with/without RBV (OBV/PTV/r/DSV ± RBV) in patients with viral genotype 1a or 1b, and who did not respond to previous peginterferon/ribavirin (PegIFNα2a+RBV) therapy.MethodsA descriptive, ambispective, longitudinal study was conducted. A cohort of 261 adult patients received PegIFNα2a+RBV therapy before 2014; 167 (64%) did not respond, 83 of these were subsequently treated with SOF/LDV ± RBV or OBV/PTV/r/DSV ± RBV. Child-Pugh-Score (CPS), Fibrosis-4 (FIB-4), and AST to Platelet Ratio Index (APRI) were evaluated before and after treatment.ResultsSVR with PegIFNα2a+RBV was 36%, and 97.5% with DAAs. CPS, FIB-4 and APRI improved significantly after DAA treatment, mainly because of liver transaminase reduction.ConclusionsDAA treatment showed excellent SVR rates in Mexican patients who had not responded to PegIFNα2a+RBV therapy. Improvement in CPS, FIB-4 and APRI without improvement in fibrosis was observed in cirrhotic and non-cirrhotic patients, as well as considerable reduction in liver transaminases, which suggests a reduction in hepatic necroinflammation.

【 授权许可】

CC BY