Effectiveness and tolerability of direct-acting antivirals for chronic hepatitis C patients in a Southern state of Brazil

Effectiveness and tolerability of direct-acting antivirals for chronic hepatitis C patients in a Southern state of Brazil

Brazilian Journal of Infectious Diseases, May 2018

29752891

Vinicius Lins Ferreira, Helena Hiemisch Lobo Borba, Astrid Wiens, Maria Lucia Alves Pedroso, Vanessa Ferreira de Camargo Radunz, Cláudia Alexandra Pontes Ivantes, Aline Satie Oba Kuniyoshi, Roberto Pontarolo

This study aimed to evaluate the clinical effectiveness in terms of sustained virological response (SVR) and tolerability of available second generation direct-acting antivirals (DAAs) in Brazilian patients. This was a retrospective observational study conducted in six centers in Southern Brazil. The sample comprised adult patients who were chronically infected with hepatitis C virus (HCV), regardless of virus genotype, fibrosis stage, or prior treatment. Statistical analysis was performed to compare the effectiveness among the treatments, and also to uncover the factors influencing the achievement of SVR. A total of 296 patients were included in the study, with the majority receiving sofosbuvir with daclatasvir (59%) or sofosbuvir with simeprevir (26%). Overall SVR rates were approximately 91.6%. For genotype 1, sofosbuvir with daclatasvir had an SVR rate of approximately 95%, while the SVR rate of sofosbuvir with simeprevir was 92%; this difference was statistically significant only for subtype 1b. The only treatment used for genotype 3 patients was sofosbuvir with daclatasvir, and lower rates of SVR were observed for this group, compared to genotype 1 (84% versus 95%, p<0.05). Apart from this difference between genotypes, and a difference between patients who achieved rapid virologic response compared with those who did not, there were no other statistically significant factors associated with SVR. The results point to the effectiveness of second-generation DAAs in HCV Brazilian patients, especially those with genotype 1. Furthermore, that patients with genotype 3 need more attention and adjustments in available treatment options.