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Durability of Sustained Virologic Response and Improvement of Fibrosis Markers after Daclatasvir and Asunaprevir Treatment in Genotype 1b Hepatitis C Virus-Infected Patients: a Real Life and Multicenter Study.

Authors
  • Shin, Seung Kak1
  • Lee, Jin Woo2
  • Ra, Hannah1
  • Kwon, Oh Sang3
  • Shin, Jong Beom2
  • Jin, Young Joo2
  • Lee, Sangheun4
  • Han, Ki Jun4
  • Kim, Young Nam5
  • Kim, Tae Hun6
  • Kim, Yun Soo1
  • Kim, Ju Hyun1
  • 1 Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. , (North Korea)
  • 2 Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. , (North Korea)
  • 3 Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. [email protected] , (North Korea)
  • 4 Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea. , (North Korea)
  • 5 Department of Internal Medicine, Cheju Halla General Hospital, Jeju, Korea. , (North Korea)
  • 6 Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
Journal of Korean medical science
Publication Date
Oct 28, 2019
Volume
34
Issue
41
Identifiers
DOI: 10.3346/jkms.2019.34.e264
PMID: 31650719
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The long-term data with direct acting antiviral agents were rare. This study investigated the durability of a sustained virologic response (SVR) and the improvement of fibrosis after daclatasvir and asunaprevir (DCV/ASV) treatment in genotype 1b (GT1b) hepatitis C virus (HCV)-infected patients. A total of 288 HCV GT1b patients without baseline non-structural 5A (NS5A) resistance-associated substitution (RAS) treated with DCV/ASV were enrolled. Virologic response was measured at 12 weeks and 1 year after treatment completion. In cirrhotic patients, liver function, aspartate transaminase to platelet ratio index (APRI), FIB-4 index, fibrosis index (FI), and liver stiffness measurement (LSM) at baseline and 1 year after treatment completion were evaluated. SVR12 was obtained in 278 patients (96.5%). Six patients who checked NS5A RAS after treatment failure were RAS positive. Only one patient showed no durability of SVR. In cirrhotic patients who achieved SVR12 (n = 59), the changes of albumin (3.8 [2.2-4.7] to 4.3 [2.4-4.9] g/dL; P < 0.001), platelet count (99 [40-329] to 118 [40-399] × 10³/mm³; P < 0.001), APRI (1.8 [0.1-14.8] to 0.6 [0.1-4.8]; P < 0.001), FIB-4 index (5.45 [0.6-32.8] to 3.3 [0.4-12.2]; P < 0.001), FI (5.5 [0.6-32.8] to 3.3 [0.4-12.2]; P < 0.001), and LSM (17.2 [5.3-48.0] to 11.2 [3.7-28.1] kPa; P = 0.001) between baseline and 1 year after treatment completion were observed. DCV/ASV treatment for HCV GT1b infected patients without RAS achieved high SVR rates and showed durable SVR. Cirrhotic patients who achieved SVR12 showed the improvement of liver function and fibrosis markers. © 2019 The Korean Academy of Medical Sciences.

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