المؤلفون: Revuelto Artigas, Tamara

المساهمون: University/Department: Universitat de Lleida. Departament de Medicina

مرشدي الرسالة: Reñé Espinet, Josep Maria, Betriu i Bars, M. Àngels, Piñol Felis, Carme

المصدر: TDX (Tesis Doctorals en Xarxa)

مصطلحات موضوعية: Infecció VHC, Ateromatosi subclínica, Antivirales d'acció directa, Infección VHC, Ateromatosis subclínica, Antivirales acción directa, HCV infection, Subclinical atheromatosis, Direct-acting antivirals, Medicina

الوصف: OBJECTIU: Analitzar si la infecció VHC és un factor de risc independent d`ateromatosi subclínica i conèixer les característiques que influeixen en la composició de les plaques, així com la seva modificació després de 12 mesos de la teràpia amb Antivirales d'acció directa (AAD). MATERIAL I MÈTODES: Estudi prospectiu que compara 185 pacients VHC amb diferents genotips i fibrosi hepàtica abans d'AAD, davant de 411 subjectes sense infecció, amb similar risc cardiovascular. L`ateromatosi subclínica (GIM i presència de plaques) i composició de la placa (programari HEMODYN 4) es va avaluar amb ecografia en territori carotidi i femoral a l'inici i després de 12 mesos de AAD. RESULTATS: Es va detectar major GIM (0,83 vs 0,73mm; p = 0,045), placa d'ateroma (63% vs 44%; p <0,001) amb composició lipídica (50% vs 29%; p <0,001) en els pacients VHC que en controls. El percentatge de lípids es va associar amb edat i VHC (p <0,001) .Els factors de risc de ateromatosi van ser la infecció VHC (OR = 2,64), el sexe masculí (OR = 2,79), l'edat (OR = 1,08, amb un RR = 3,11 en pacients infectats menors de 55anys), el tabaquisme (OR = 3,25), la tensió arterial (OR = 1,02) i l'índex de insulinoresistència (TiG, OR = 3 , 18). Pel que fa a les característiques virals, només va influir el genotip (OR = 2,46, amb un risc de placa G2 45,4%, G1 55,3%, G4 78,8% i G3 94,4%) independent de la fibrosi hepàtica. Després de 12 mesos de la resposta viral sostinguda amb AAD, avaluem 85 pacients sense detectar modificació del GIM (0,74 vs 0,81mm; p = 0,068) ni a la placa (66% vs el 72%; p = 0,063). En la composició, es va observar una lleu tendència a la disminució de lípids no significativa (49,5 vs 47%; p = 0,305). Després d'aquest període, vam detectar una millora de l'esteatosi i fibrosi hepàtica, però un augment dels nivells sèrics de colesterol (p <0,001). CONCLUSIONS: La infecció crònica per VHC és factor de risc independent d`ateromatosi subclínica accelerada amb plaques predominantment lipídiques, l'ecografia arterial és un mètode no invasiu per a l'avaluació del risc cardiovascular. Després de 12 mesos de l'eradicació del VHC amb AAD no millora l'ateromatosi globalment ni en ajustar per factors vasculars o severitat fibrosi hepàtica.

الوصف (مترجم): OBJETIVO: Analizar si la infección VHC es un factor de riesgo independiente de ateromatosis subclínica y conocer las características que influyen en la composición de las placas, así como su modificación tras 12 meses de la terapia con Antivirales de acción directa (AAD). MATERIAL Y MÉTODOS: Estudio prospectivo que compara 185 pacientes VHC con diferentes genotipos y fibrosis hepática antes de AAD, frente a 411 sujetos sin infección, con similar riesgo cardiovascular. La ateromatosis subclínica (GIM y presencia de placas) y composición de la placa (software HEMODYN 4) se evaluó con ecografía en territorio carotídeo y femoral al inicio y tras 12 meses de AAD. RESULTADOS: Se detectó mayor GIM (0,83 vs 0,73mm; p=0,045), placa de ateroma (63% vs 44%; p<0,001) con composición lipídica (50% vs 29%; p<0,001) en los pacientes VHC que en controles. El porcentaje de lípidos se asocio con edad y VHC (p<0,001).Los factores de riesgo de ateromatosis fueron la infección VHC (OR=2,64), el sexo masculino (OR=2,79), la edad (OR=1,08, con un RR=3,11 en pacientes infectados menores de 55años), el tabaquismo (OR=3,25), la tensión arterial (OR=1,02) y el índice de insulinorresistencia (TyG, OR=3,18). Respecto a las características virales, solo influyó el genotipo (OR=2,46, con un riesgo de placa G2 45,4%, G1 55,3%, G4 78,8% y G3 94,4%) independiente de la fibrosis hepática. Tras 12meses de la respuesta viral sostenida con AAD, evaluamos 85 pacientes sin detectar modificación del GIM (0,74 vs 0,81mm; p=0,068) ni en la placa (66% vs 72%; p=0,063). En la composición, se observó una leve tendencia a la disminución de lípidos no significativa (49,5 vs 47%; p=0,305). Tras este periodo, detectamos una mejoría de la esteatosis y fibrosis hepática, pero un aumento de los niveles séricos de colesterol (p<0,001). CONCLUSIONES: La infección crónica por VHC es factor de riesgo independiente de ateromatosis subclínica acelerada con placas predominantemente lipídicas, la ecografía arterial es un método no invasivo para la evaluación del riesgo cardiovascular. Tras 12meses de la erradicación del VHC con AAD no mejora la ateromatosis globalmente ni al ajustar por factores vasculares o severidad de fibrosis hepática.
OBJECTIVE: To analyze whether HCV infection is an independent risk factor for subclinical atheromatosis and to know the characteristics that influence the composition of the plaques, as well as its modification after 12 months of direct action antiviral therapy (DAA). MATERIAL AND METHODS: Prospective study comparing 185 HCV patients with different genotypes and liver fibrosis before AAD, compared to 411 subjects without infection, with similar cardiovascular risk. Subclinical atheromatosis (IMT and presence of plaques) and plaque composition (software HEMODYN 4) was evaluated with ultrasound in the carotid and femoral territory at the beginning and after 12 months of DAA. RESULTS: Higher MIC was detected (0.83 vs 0.73 mm, p = 0.045), atheroma plaque (63% vs 44%, p <0.001) with lipid composition (50% vs 29%, p <0.001) in the HCV patients than in controls. The percentage of lipids was associated with age and HCV (p <0.001). The risk factors for atheromatosis were HCV infection (OR = 2.64), male sex (OR = 2.79), age (OR = 1.08, with RR = 3.11 in infected patients under 55 years of age), smoking (OR = 3.25), blood pressure (OR = 1.02) and the insulin resistance index (TyG, OR = 3 , 18). Regarding the viral characteristics, only the genotype influenced (OR = 2.46, with a risk of G2 plaque 45.4%, G1 55.3%, G4 78.8% and G3 94.4%) independent of fibrosis hepatic After 12 months of the sustained viral response with DAA, we evaluated 85 patients without detecting a change in the IMT (0.74 vs 0.81 mm, p = 0.068) or in the plaque (66% vs 72%, p = 0.063). In the composition, there was a slight tendency to decrease lipids not significant (49.5 vs 47%, p = 0.305). After this period, we detected an improvement in steatosis and liver fibrosis, but an increase in serum cholesterol levels (p <0.001). CONCLUSIONS: Chronic HCV infection is an independent risk factor for accelerated subclinical atheromatosis with predominantly lipid plaques; arterial ultrasound is a non-invasive method for evaluating cardiovascular risk. After 12 months of eradication of HCV with DAA, atheromatosis does not improve globally nor does it adjust for vascular factors or severity of liver fibrosis.

وصف الملف: application/pdf

الوصول الحر: http://hdl.handle.net/10803/667849Test

المؤلفون: Nawaz, Allah, Manzoor, Azhar, Ahmed, Saeed, Ahmed, Naveed, Abbas, Waseem, Mir, Mushtaq Ahmad, Bilal, Muhammad, Sheikh, Alisha, Ahmad, Saleem, Jeelani, Ishtiaq, Nakagawa, Takashi

مصطلحات موضوعية: hepatitis C virus, direct-acting antiviral agents, botanical drugs, hepatitis C, hepatoprotective and antiviral properties of medicinal plants, Pharmacology and Pharmaceutical Sciences, Pharmacology and pharmaceutical sciences

الوصف: Hepatitis C virus (HCV) infection is a significant global health concern, prompting the need for effective treatment strategies. This in-depth review critically assesses the landscape of HCV treatment, drawing parallels between traditional interferon/ribavirin therapy historically pivotal in HCV management and herbal approaches rooted in traditional and complementary medicine. Advancements in therapeutic development and enhanced clinical outcomes axis on a comprehensive understanding of the diverse HCV genome, its natural variations, pathogenesis, and the impact of dietary, social, environmental, and economic factors. A thorough analysis was conducted through reputable sources such as Science Direct, PubMed, Scopus, Web of Science, books, and dissertations. This review primarily focuses on the intricate nature of HCV genomes and explores the potential of botanical drugs in both preventing and treating HCV infections.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9sw4w496Test

المؤلفون: Parveen Fathima, Mark Jones, Reena D’Souza, James Totterdell, Nada Andric, Penelope Abbott, Richard Norman, Kirsten Howard, Wendy Cheng, Alisa Pedrana, Joseph S. Doyle, Jane Davies, Thomas Snelling

المصدر: Trials, Vol 25, Iss 1, Pp 1-14 (2024)

مصطلحات موضوعية: Randomised study, Dose–response, Bayesian design, Adaptive study, Direct-acting antiviral, Financial incentives, Medicine (General), R5-920

الوصف: Abstract Background Untreated hepatitis C virus (HCV) infection can result in cirrhosis and hepatocellular cancer. Direct-acting antiviral (DAA) therapies are highly effective and have few side effects compared to older interferon-based therapy. Despite the Australian government providing subsidised and unrestricted access to DAA therapy for chronic HCV infection, uptake has not been sufficient to meet the global target of eliminating HCV as a public health threat by 2030. This study will offer people with HCV financial incentives of varying values in order to evaluate its effect on initiation of DAA therapy in primary care. Methods Australian adults (18 years or older) who self-report as having current untreated HCV infection can register to participate via an automated SMS-based system. Following self-screening for eligibility, registrants are offered a financial incentive of randomised value (AUD 0 to 1000) to initiate DAA therapy. Study treatment navigators contact registrants who have consented to be contacted, to complete eligibility assessment, outline the study procedures (including the requirement for participants to consult a primary care provider), obtain consent, and finalise enrolment. Enrolled participants receive their offered incentive on provision of evidence of DAA therapy initiation within 12 weeks of registration (primary endpoint). Balanced randomisation is used across the incentive range until the first analysis, after which response-adaptive randomisation will be used to update the assignment probabilities. For the primary analysis, a Bayesian 4-parameter EMAX model will be used to estimate the dose–response curve and contrast treatment initiation at each incentive value against the control arm (AUD 0). Specified secondary statistical and economic analyses will evaluate the effect of incentives on adherence to DAA therapy, virological response, and cost-effectiveness. Discussion This project seeks to gain an understanding of the dose–response relationship between incentive value and DAA treatment initiation, while maximising the number of people treated for HCV within fixed budget and time constraints. In doing so, we hope to offer policy-relevant recommendation(s) for the use of financial incentives as a pragmatic, efficient, and cost-effective approach to achieving elimination of HCV from Australia. Trial registration ANZCTR (anzctr.org.au), Identifier ACTRN12623000024640, Registered 11 January 2023 ( https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384923&isReview=trueTest ).

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/da79493bad0a407286619bccafb836caTest

المؤلفون: Hao Xiong, Jinsheng Guo

المصدر: Exploration of Digestive Diseases, Vol 3, Iss 3, Pp 226-240 (2024)

مصطلحات موضوعية: hepatitis c virus, chronic hepatitis c, liver cirrhosis, direct-acting antiviral agents, pan-genotypic regimen, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Hepatitis C viral infections present a significant global health challenge, carrying substantial economic implications. These infections manifest in various clinical forms, including acute and chronic hepatitis, liver cirrhosis, hepatic failure, and hepatocellular carcinoma (HCC). Liver cirrhosis and HCC emerge as the primary contributors to mortality in hepatitis virus-induced liver diseases. To alleviate the public health impact of this disease, it is imperative to enhance the diagnosis and treatment rates among hepatitis C virus-infected individuals. The advent of direct-acting antivirals (DAAs), especially pan-genotypic regimens such as a combination of sofosbuvir and velpatasvir, has shown remarkable progress in achieving hepatitis C cure. However, potential obstacles, such as drug adverse effects and resistance-associated substitutions (RASs), warrant attention. Managing chronic hepatitis C (CHC) requires tailored treatment plans, vigilant monitoring, and judicious re-treatment strategies.

وصف الملف: electronic resource

العلاقة: https://www.explorationpub.com/Journals/edd/Article/100549Test; https://doaj.org/toc/2833-6321Test

الوصول الحر: https://doaj.org/article/4b86acf97fe04b97aaf447029b5110f1Test

المؤلفون: Salomon I, Olivier S, Egide N

المصدر: Hepatic Medicine: Evidence and Research, Vol Volume 16, Pp 37-44 (2024)

مصطلحات موضوعية: hepatitis c, elimination, africa, egypt, direct-acting antivirals, policy insights, hepatitis virus, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Izere Salomon,1,2 Sibomana Olivier,1 Ndayambaje Egide1 1Department of General Medicine and Surgery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; 2YP-CDN Rwanda (Rwanda Young Professional Chronic Disease Network), Kigali RwandaCorrespondence: Izere Salomon, Email izesajw73@gmail.comAbstract: The hepatitis C virus (HCV) poses a significant risk to global public health and is linked to life-threatening clinical outcomes. According to the WHO, there are an estimated 58 million people worldwide who have a chronic hepatitis C virus (HCV) infection; there are 1.5 million new cases and more than 350,000 fatalities from HCV-related illnesses each year. Even though there are numerous diagnostic techniques, the lack of funding, inadequate healthcare infrastructure, and low public awareness of the Hepatitis C virus can make diagnosis and treatment difficult to obtain throughout the continent. The frequency of hepatitis C virus infection is highest in African nations (1– 26%), raising serious concerns about the virus’s impact on public health. The world’s highest rate of Hepatitis C virus infection was found in Egypt, an African nation. Its nationwide hepatitis C elimination program stands out as a prime example of achievement, having screened, and treated over 60 million people, significantly reducing the disease’s incidence and prevalence. Other African nations facing similar difficulties might benefit greatly from Egypt’s methods, which provide valuable insights and flexible frameworks. This review aims to shed light on Egypt’s successes and challenges while offering strategic recommendations to African nations to quicken their progress in eliminating hepatitis C.Keywords: hepatitis C, elimination, Africa, Egypt, direct-acting antivirals, policy insights, hepatitis virus

وصف الملف: electronic resource

العلاقة: https://www.dovepress.com/advancing-hepatitis-c-elimination-in-africa-insights-from-egypt-peer-reviewed-fulltext-article-HMERTest; https://doaj.org/toc/1179-1535Test

الوصول الحر: https://doaj.org/article/9f1eeaef64ff49cca263771c5c99eb16Test

المؤلفون: Tomoko Tadokoro, Joji Tani, Takushi Manabe, Kei Takuma, Mai Nakahara, Kyoko Oura, Shima Mimura, Koji Fujita, Takako Nomura, Asahiro Morishita, Hideki Kobara, Takashi Himoto, Masafumi Ono, Tsutomu Masaki

المصدر: Scientific Reports, Vol 14, Iss 1, Pp 1-10 (2024)

مصطلحات موضوعية: Cirrhosis, Direct-acting oral anticoagulants, Portal vein thrombosis, Warfarin, Medicine, Science

الوصف: Abstract Portal vein thrombosis (PVT) worsens the long-term prognosis of patients with cirrhosis; however, the optimal treatment remains to be determined. Reports on the efficacy of direct oral anticoagulants are increasing, and further evidence is needed. Therefore, we investigated the effectiveness of treatment with edoxaban in patients with PVT. We retrospectively reviewed the outcomes of edoxaban and warfarin as antithrombotic therapies for PVT. The median overall survival time was 4.2 years in patients with PVT, with a 1-year survival rate of 70.7% and a 5-year survival rate of 47.9%. The leading cause of death was hepatocellular carcinoma. The overall response rate for thrombolysis in the edoxaban group was 76.7% compared to 29.4% in the warfarin group, and edoxaban significantly improved PVT compared to warfarin. In addition, edoxaban provided long-term improvement of PVT. Warfarin, on the other hand, was temporarily effective but did not provide long-term benefits. The Child–Pugh and albumin-bilirubin scores did not change after edoxaban or warfarin use. No deaths occurred due to adverse events associated with edoxaban or warfarin. Edoxaban as a single agent can achieve long-term recanalization without compromising the hepatic reserves. Edoxaban is easy to initiate, even in an outpatient setting, and could become a major therapeutic agent for the treatment of PVT.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/edf0293d1b7b41aca4d8da2b8ed176f0Test

المؤلفون: Mohamed Elgazzar, Tary Salman, Eman Abdelsameea, Mohamed Akl, Nabil Omar, Mohamed Abdel-Samiee, Shrif Abas, Mohmoud Elsakhawy, Ahmed Elsherif, Ibrahim Abdelkader, Dina Elazab, Nermine Ehsan, Mohamed Mohamady, Mohamed El-Kassas, Hazem Metwaly Omar

المصدر: The Egyptian Journal of Radiology and Nuclear Medicine, Vol 55, Iss 1, Pp 1-8 (2024)

مصطلحات موضوعية: Hepatocellular carcinoma, Hepatitis C virus, Direct acting antivirals, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Abstract Background Hepatocellular carcinoma (HCC) is the first cause of cancer in Egypt. Recently, HCC developed post direct-acting antivirals (DAAs) differ in some characteristics from those developed without DAAs exposure regarding the biological features and behavior of HCC. We aimed to assess the epidemiological, clinical, laboratory, and radiological findings besides the biological behavior of HCC patients post DAAs in comparison to HCC not exposed to DAAs. An analytic cross-sectional research was performed at the National Liver Institute which is a tertiary multidisciplinary HCC center. Subjects included hepatitis C virus patients and were allocated into two groups: group I included 2036 HCC cases post-DAA treatment and group II included 6338 HCC cases who did not receive DAAs. Subjects were examined to evaluate clinical, laboratory, and radiological findings. Tumor staging was done using the BCLC staging system. Results Group II showed a more advanced Child–Pugh score, FIB-4 index, and MELD score than Group I (P = 0.001). The multiplicity of hepatic focal lesions was elevated in group I than in group II (P = 0.033). AFP level was significantly elevated in group I than in group II (p = 0.012). Portal vein invasion was significantly elevated in group I than in group II patients (P = 0.001). Extrahepatic spread of HCC was significantly elevated in group I than in group II (P = 0.001). Infiltrative lesions were significantly elevated in group I than in group II (P = 0.002). Conclusion Our study detected that the behavior in HCC post DAAs treatment is more aggressive in respect of the number of lesions, PV invasion; local and distant metastasis, and serum AFP level than in patients unexposed to DAAs. Strict surveillance in cirrhotic patients treated with DAA should be followed according to the international guidelines for early diagnosis and treatment of HCC.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2090-4762Test

الوصول الحر: https://doaj.org/article/363f32e037d7410191413f8acb6b91c9Test

المؤلفون: Gardner, Annelys Roque, Ma, Yifei, Bacchetti, Peter, Price, Jennifer C, Kuniholm, Mark H, French, Audrey L, Gange, Stephen, Adimora, Adaora A, Minkoff, Howard, Kassaye, Seble, Ofotokun, Igho, Rosenberg, William, Kovacs, Andrea AZ, Tien, Phyllis C

المصدر: The Journal of Infectious Diseases. 227(11)

مصطلحات موضوعية: Medical Microbiology, Biomedical and Clinical Sciences, Substance Misuse, Hepatitis, Emerging Infectious Diseases, Digestive Diseases, Hepatitis - C, Infectious Diseases, Liver Disease, Chronic Liver Disease and Cirrhosis, Alcoholism, Alcohol Use and Health, HIV/AIDS, Infection, Good Health and Well Being, Humans, Female, Hepacivirus, HIV, HIV Infections, Hepatitis C, Liver Cirrhosis, enhanced liver fibrosis score, ELF, hepatitis C, FIB-4, APRI, direct-acting antiviral therapy, Biological Sciences, Medical and Health Sciences, Microbiology, Biological sciences, Biomedical and clinical sciences, Health sciences

الوصف: BackgroundThe trajectory of liver fibrosis is not well understood in the contemporary era of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) therapy.MethodsWe assessed the Enhanced Liver Fibrosis (ELF) score, aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) in 116 women with HIV/HCV coinfection over a 4-year period. Random-effects linear regression models examined the rate of fibrosis change 1-2 years before starting HCV treatment, within 1 year before starting (peri-HCV treatment), within 1 year after and 1-2 years post-HCV treatment in unadjusted and adjusted models including age, race, and changes from pretreatment of factors that might affect fibrosis (eg, alcohol, integrase strand inhibitor [INSTI] use, waist circumference, CD4 count).ResultsINSTI use nearly doubled from pre- to peri-HCV treatment. In unadjusted analysis, there was a 3.3% rate of rise in ELF pre-HCV treatment, 2.2% and 3.6% rate of decline during the peri- and 1-year post-HCV treatment period, respectively, followed by a 0.3% rise. Similar findings were observed for APRI and FIB-4. There was little effect on the estimated fibrosis trajectories after adjustment.ConclusionsThe apparent lack of decline in biomarkers of liver fibrosis beyond 1 year after HCV cure suggests that continued monitoring of liver fibrosis and interventions to mitigate progression in people with HIV after HCV cure remains essential.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6n13w48sTest
https://escholarship.org/content/qt6n13w48s/qt6n13w48s.pdfTest

المؤلفون: Chun-Chi Yang, Chung-Feng Huang, Te-Sheng Chang, Ching-Chu Lo, Chao-Hung Hung, Chien-Wei Huang, Lee-Won Chong, Pin-Nan Cheng, Ming-Lun Yeh, Cheng-Yuan Peng, Chien-Yu Cheng, Jee-Fu Huang, Ming-Jong Bair, Chih-Lang Lin, Chi-Chieh Yang, Szu-Jen Wang, Tsai-Yuan Hsieh, Tzong-Hsi Lee, Pei-Lun Lee, Wen-Chih Wu, Chih-Lin Lin, Wei-Wen Su, Sheng-Shun Yang, Chia-Chi Wang, Jui-Ting Hu, Lein-Ray Mo, Chun-Ting Chen, Yi-Hsiang Huang, Chun-Chao Chang, Chia-Sheng Huang, Guei-Ying Chen, Chien-Neng Kao, Chi-Ming Tai, Chun-Jen Liu, Mei-Hsuan Lee, Hsing-Tao Kuo, Pei-Chien Tsai, Chia-Yen Dai, Jia-Horng Kao, Han-Chieh Lin, Wang-Long Chuang, Kuo-Chih Tseng, Chi-Yi Chen, Ming-Lung Yu

المصدر: Infectious Diseases and Therapy, Vol 13, Iss 6, Pp 1199-1213 (2024)

مصطلحات موضوعية: Hepatitis C, Direct-acting antivirals, Glecaprevir, Pibrentasvir, Real world, Taiwan, Infectious and parasitic diseases, RC109-216

الوصف: Abstract Introduction Eight-week glecaprevir/pibrentasvir (GLE/PIB) is indicated for treatment-naïve (TN) patients with chronic hepatitis C (CHC), with or without compensated cirrhosis. Given that the Taiwanese government is committed to eliminating hepatitis C virus (HCV) by 2025, this study aimed to measure real-world evidence for TN patients using 8-week GLE/PIB in the Taiwan HCV Registry (TACR). Methods The data of patients with CHC treated with 8-week GLE/PIB were retrieved from TACR, a nationwide registry program organized by the Taiwan Association for the Study of the Liver (TASL). Treatment efficacy, defined as a sustained virologic response at posttreatment week 12 (SVR12), was assessed in the modified intention-to-treat (mITT) population, which excluded patients who were lost to follow-up or lacked SVR12 data. The safety profile of the ITT population was assessed. Results A total of 7246 (6897 without cirrhosis; 349 with cirrhosis) patients received at least one dose of GLE/PIB (ITT), 7204 of whom had SVR12 data available (mITT). The overall SVR12 rate was 98.9% (7122/7204) among all patients, 98.9% (6780/6856) and 98.3% (342/348) among patients without and with cirrhosis, respectively. For the selected subgroups, which included patients with genotype 3 infection, diabetes, chronic kidney disease, people who injected drugs, and those with human immunodeficiency virus coinfection, the SVR12 rates were 95.1% (272/286), 98.9% (1084/1096), 99.0% (1171/1183), 97.4% (566/581), and 96.1% (248/258), respectively. Overall, 14.1% (1021/7246) of the patients experienced adverse events (AEs). Twenty-two patients (0.3%) experienced serious AEs, and 15 events (0.2%) resulted in permanent drug discontinuation. Only one event was considered treatment drug related. Conclusion Eight-week GLE/PIB therapy was effective and well tolerated in all TN patients, regardless of cirrhosis status.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2193-8229Test; https://doaj.org/toc/2193-6382Test

الوصول الحر: https://doaj.org/article/14215fa1ee784d7ab2393d1356d5db36Test

المؤلفون: Elena Yela, Neus Solé, Lidia Puig, Darío López Gallegos, Rafael Clua-García

المصدر: Harm Reduction Journal, Vol 21, Iss 1, Pp 1-11 (2024)

مصطلحات موضوعية: Hepatitis C, People who inject drugs, Direct-acting antivirals, Harm reduction, Qualitative, Spain, Public aspects of medicine, RA1-1270

الوصف: Abstract Barriers to access to hepatitis C treatment with direct-acting antivirals in people who inject drugs in the community setting. Qualitative study with prison population. Hepatitis C (HCV) treatments with direct-acting antiviral therapy (DAA) are an easy and effective option among people who inject drugs (PWID). However, difficulties in accessing and monitoring treatment in community services and dropouts on release from prison are detected among PWID. For this reason, the aim of the study is to know the access barriers in the diagnosis and treatment of HCV in community health services. An exploratory qualitative study was carried out through semi-structured interviews with 33 PWID recruited in a pre-trial detention prison in Barcelona. The information obtained was analysed using grounded theory. Among PWID sub-population entering prison, personal barriers are related to intense drug use, lack of interest and ignorance of HCV infection and treatment, as well as being in a situation of social exclusion. In relation to health providers, they reported receiving little information, the existence of language barriers in migrants, not receiving screening and treatment proposals, and having poor interactions with some professionals. Systemic barriers were expressed related to the health system circuit being complicated, perceiving little comprehensive care and lack of community support. It is recommended to intensify prevention and treatment campaigns, promoting drug substitution programmes than current ones, improve health education, make the diagnosis and treatment process more flexible, and promote social policies and holistic care for greater coverage of the needs of PWID.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1477-7517Test

الوصول الحر: https://doaj.org/article/0895efaef22b4889832a19e4517c97d3Test