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Safe and effective sofosbuvir-based therapy in patients with mental health disease on hepatitis C virus treatment

World Journal of Hepatology 2016年第31期8卷 1318-1326页

作者： Lydia Shuk Yee Tang Jack Masur Zayani Sims Amy Nelson Anu Osinusi Anita Kohli Sarah Kattakuzhy Michael Polis shyam kottilil Institute of Human Virology Division of Infectious Diseases University of Maryland School of Medicine Critical Care Medicine Department Clinical CenterNational Institutes of Health Gilead Sciences Inc Creighton University School of Medicine St Joseph’s Hospital Laboratory of Immunoregulation National Institute of Allergy and Infectious Diseases National Institutes of Health

AIMTo study impact of baseline mental health disease on hepatitis C virus (HCV) treatment; and Beck’s Depression Inventory (BDI) changes with sofosbuvir- and interferon-based therapy. METHODSThis is a retrospective cohort study of participants from 5 studies enrolled from single center trials conducted at the Clinical Research Center of the National Institutes of Health, Bethesda, MD, United States. All participants were adults with chronic HCV genotype 1 infection and naïve to HCV therapy. Two of the studies included HCV mono-infected participants only (SPARE, SYNERGY-A), and 3 included human immunodeficiency virus (HIV)/HCV co-infected participants only (ERADICATE, PFINPK, and ALBIN). Patients were treated for HCV with 3 different regimens: Sofosbuvir and ribavirin in the SPARE trial, ledipasvir and sofosbuvir in SYNERGY-A and ERADICATE trials, and pegylated interferon (IFN) and ribavirin for 48 wk in the PIFNPK and ALBIN trials. Participants with baseline mental health disease (MHD) were identified (defined as either a DSM IV diagnosis of major depression, bipolar disorder, schizophrenia, generalized anxiety, and post-traumatic stress disorder or requiring anti-depressants, antipsychotics, mood stabilizers or psychotropics prescribed by a psychiatrist). For our first aim, we compared sustained virologic response (SVR) and adherence (pill counts, study visits, and in 25 patients, blood levels of the sofosbuvir metabolite, GS-331007) within each study. For our second aim, only patients with HIV coinfection were evaluated. BDI scores were obtained pre-treatment, during treatment, and post-treatment among participants treated with sofosbuvir-based therapy, and compared to scores from participants treated with interferon-based therapy. Statistical differences for both aims were analyzed by Fisher’s Exact, and t-test with significance defined as a P value less than 0.05. RESULTSBaseline characteristics did not differ significantly between all participa

关键词： Sofosbuvir Direct acting antivirals Directly acting antiviral Hepatitis C Mental health disease Depression Interferon Beck&rsquo s Depression Inventory

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Use of Ribavirin for Hepatitis C Treatment in the Modern Direct-acting Antiviral Era

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Journal of Clinical and Translational Hepatology 2018年第4期6卷 431-437页

作者： Poonam Mathur shyamasundaran kottilil Eleanor Wilson Division of Clinical Care and Research Institute of Human VirologyUniversity of Maryland School of MedicineBaltimoreMDUSA

Ribavirin,once a staple of hepatitis C treatment,has significant drawbacks,including treatment-limiting side effects,the requirement for intensive laboratory monitoring,the need for frequent dose adjustments,and *** factors make it difficult to escalate ribavirin-based HCV treatment to most infected patients *** studies have shown comparable response rates between ribavirin-inclusive and ribavirin-sparing regimens in uncomplicated patient ***,ribavirin is still used in the management of patients who have failed previous therapy as well as those with decompensated liver *** this review,we explore the evidence supporting the use of ribavirin in the current climate of hepatitis C treatment with oral combination direct-acting antiviral agents.

关键词： Chronic hepatitis C Direct-acting antivirals Ribavirin

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