Effectiveness of chronic hepatitis C treatment with direct-acting antivirals in the Public Health System in Brazil

Braz J Infect Dis. 2018 Jul-Aug;22(4):317-322. doi: 10.1016/j.bjid.2018.06.004. Epub 2018 Jul 21.

Abstract

Introduction: Chronic hepatitis C virus infection is one of the major causes of cirrhosis, hepatocellular carcinoma and liver transplantation. Treatment using direct-acting antivirals has revolutionized the treatment of hepatitis C virus, increasing long-term prognosis after cure. The goal of the present study was to evaluate the effectiveness of direct-acting antivirals in a Public Health System in southern Brazil.

Methods: A retrospective study evaluated all patients with chronic hepatitis C virus infection who underwent treatment at one center of the Public Health Department of the State of Rio Grande do Sul - Brazil, according to the Brazilian Clinical Protocol and Therapeutic Guidelines. The effectiveness was assessed in terms sustained virological response 12 weeks after the end of treatment.

Results: A total of 1002 patients who were treated for chronic hepatitis C virus infection were evaluated. The mean age was 58.6 years, 557 patients (55.6%) were male and 550 (54.9%) were cirrhotic. Overall sustained virological response was observed in 936 (93.4%) patients. There was a difference in sustained virological response rate varied according to sex, 91.6% in men and 95.7% in women (p = 0.009), length of treatment in genotype 1, 92.7% with 12 weeks and 99.1 with 24 weeks (p = 0.040), and genotype, 94.7% in genotype 1, 91.7% in genotype 2, and 91.4% in genotype 3 (p = 0.047).

Conclusion: The treatment of chronic hepatitis C virus infection for genotypes 1, 2 or 3 with the therapeutic regimens established by the Brazilian guidelines showed high rates of SVR, even in cirrhotic patients.

Keywords: DAA; Daclatasvir; Simeprevir; Sofosbuvir; Sustained virological response.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents / therapeutic use*
  • Brazil
  • Carbamates
  • Drug Therapy, Combination
  • Female
  • Genotype
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / genetics
  • Humans
  • Imidazoles / therapeutic use
  • Liver Cirrhosis
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Public Health* / statistics & numerical data
  • Pyrrolidines
  • Retrospective Studies
  • Ribavirin / therapeutic use
  • Simeprevir / therapeutic use
  • Sofosbuvir / therapeutic use
  • Sustained Virologic Response*
  • Valine / analogs & derivatives
  • Viral Load

Substances

  • Antiviral Agents
  • Carbamates
  • Imidazoles
  • Pyrrolidines
  • Ribavirin
  • Simeprevir
  • Valine
  • daclatasvir
  • Sofosbuvir