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Direct-acting antivirals for chronic hepatitis C treatment: The experience of two tertiary university centers in Brazil

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World Journal of Hepatology 2022年第1期14卷 195-208页

作者： Mariana Sandoval Lourenço patricia momoyo y zitelli Marlone Cunha-Silva Arthur Ivan N Oliveira Cláudia P Oliveira Tiago Sevá-Pereira Flair JoséCarrilho Mario G Pessoa Daniel F Mazo Division of Gastroenterology Department of Internal MedicineSchool of Medical SciencesUniversity of CampinasSao Paulo 13083-878Brazil Division of Clinical Gastroenterology and Hepatology Department of GastroenterologyUniversity of São Paulo School of MedicineSao Paulo 05403-900Brazil

BACKGROUND Hepatitis C virus(HCV)treatment has undergone major changes in recent *** interferon-based therapies have been replaced by oral direct-acting antivirals(DAA)regimens,with high sustained virologic response(SVR)rates,and a lower incidence of adverse events(AEs).AIM To evaluate the efficacy and safety of DAAs for HCV treatment in subjects from two tertiary university centers in *** This is a multicenter retrospective cohort study of 532 patients with chronic hepatitis C(CHC),undergoing treatment with interferon-free regimens from November 2015 to November *** therapeutic regimen was defined by the current Brazilian guidelines for HCV management at the time of ***,anthropometric,clinical,and laboratory variables were *** were assessed at 12 to 24 wk after therapy by intention-to-treat(ITT),and modified ITT(m-ITT)*** and serious adverse events(SAEs)were *** the statistical analysis,a P value ofyears,with 415(78.5%)being HCV genotype 1,followed by genotype 3(20.1%).Moreover,306(57.5%)subjects had cirrhosis,and a third of them had decompensated ***(SOF)plus daclatasvir±ribavirin was the most frequently used treatment(66.9%),followed by SOF plus simeprevir(21.2%).The overall ITT SVR was 92.6%(493/532),while the m-ITT SVR was 96.8%(493/509).Variables associated with treatment failure via ITT evaluation were hepatic encephalopathy(OR:4.320;95%CI:1.920-9.721,P=0.0004),presence of esophageal varices(OR:2.381;95%CI:1.137-4.988,P=0.0215),previous portal hypertensive bleeding(OR:2.756;95%CI:1.173-6.471,P=0.02),higher model for end-stage liver disease scores(OR:1.143,95%CI:1.060–1.233,P=0.0005),lower serum albumin levels(OR:0.528,95%CI:0.322-0.867,P=0.0115),higher serum creatinine(OR:1.117,95%CI:1.056-1.312,P=0.0033),and international normalized ratio(INR)levels(OR:5.542,95%CI:2.023-15.182,P=0.0009).AEs were reported

关键词： Chronic hepatitis C Antiviral agents Hepatitis C virus Sustained virologic response Liver cirrhosis Safety

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A potential clinical based score in hepatitis C viruscirrhotic patients to exclude small hepatocellular carcinoma

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Hepatoma Research 2018年第4期4卷 14-24页

作者： Denise Cerqueira Paranaguá-Vezozzo Celso Eduardo Lourenco Matielo Daniel Ferraz de Campos Mazo Lucas Souto Nacif Mario Guimaraes Pessoa Gleicy Luz Reinoso Pereira Roque Gabriel Rezende de Lima patricia momoyo yoshimura zitelli Suzane Kioko Ono Flair JoséCarrilho Division of Gastroenterology and Hepatology Department of GastroenterologyUniversity of Sao Paulo School of MedicineSao Paulo 05403-900Brazil Sao Paulo Clínicas Liver Cancer Group Sao PauloCancer Institute of Sao PauloUniversity of Sao Paulo School of MedicineSao Paulo 01246-000Brazil Division of Gastroenterology(Gastrocentro) School of Medical SciencesUniversity of CampinasCampinas 13083-878Brazil

Aim: Hepatitis C virus (HCV) cirrhosis is an important cause of hepatocellular carcinoma (HCC). This study aimed to identify factors of HCC presence among HCV cirrhotic patients with and without small diameter HCC (≤ 3 cm). Methods: A case control transversal study between 1998 and 2003 including 93 patients: 31 with small diameter HCC and 62 without HCC. Groups were matched by age and gender. Multiple logistic regression analysis using Akaike Information Criteria to estimate the probability of HCC was performed. A model score was generated and bootstrap analysis was performed for internal validation. Results: Three significant laboratorial variables for HCC presence were found: alanine aminotransferase > 37 U/L [odds ratio (OR): 7.43 (1.61-34.19),P = 0.01], alpha-fetoprotein > 20 ng/mL [OR: 16.2 (4.17-63.01),P y and practical model score was generated. It may be an auxiliary tool for identification of HCV patients with low probability of small diameter HCC at initial evaluation composed of three serum examinations used in routine outpatient clinical practice.

关键词： Clinical score hepatocellular carcinoma hepatitis C

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