Effectiveness of Glecaprevir/Pibrentasvir for Hepatitis C: Real-World Experience and Clinical Features of Retreatment Cases

被引:12
|
作者
Sugiura, Ayumi [1 ]
Joshita, Satoru [1 ]
Yamashita, Yuki [1 ]
Yamazaki, Tomoo [1 ]
Fujimori, Naoyuki [1 ]
Kimura, Takefumi [1 ]
Matsumoto, Akihiro [1 ,2 ]
Wada, Shuichi [3 ]
Mori, Hiromitsu [3 ]
Shibata, Soichiro [3 ]
Yoshizawa, Kaname [4 ]
Morita, Susumu [4 ]
Furuta, Kiyoshi [5 ]
Kamijo, Atsushi [5 ]
Iijima, Akihiro [6 ]
Kako, Satoko [6 ]
Maruyama, Atsushi [7 ]
Kobayashi, Masakazu [8 ]
Komatsu, Michiharu [8 ]
Matsumura, Makiko [9 ]
Miyabayashi, Chiharu [10 ]
Ichijo, Tetsuya [11 ]
Takeuchi, Aki [12 ]
Koike, Yuriko [13 ]
Gibo, Yukio [14 ]
Tsukadaira, Toshihisa [15 ]
Inada, Hiroyuki [16 ]
Nakano, Yoshiyuki [17 ]
Usuda, Seiichi [18 ]
Kiyosawa, Kendo [18 ]
Tanaka, Eiji [19 ]
Umemura, Takeji [1 ,20 ]
机构
[1] Shinshu Univ, Dept Med, Div Gastroenterol & Hepatol, Sch Med, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan
[2] Shinshu Univ Hosp, Consultat Ctr Hepat Dis, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan
[3] Japanese Red Cross Soc Nagano Hosp, Dept Gastroenterol, 22-1 Wakasato, Nagano, Nagano 3800928, Japan
[4] Natl Hosp Org, Shinshu Ueda Med Ctr, Dept Gastroenterol, 27-21 Midorigaoka, Ueda, Nagano 3868610, Japan
[5] Natl Hosp Org, Matsumoto Med Ctr, Dept Gastroenterol, 20-30 Muraimachiminami, Matsumoto, Nagano 3998701, Japan
[6] Nagano Prefectural Kiso Hosp, Dept Internal Med, 6613-4 Fukushima, Kiso, Nagano 3978555, Japan
[7] Ina Cent Hosp, Dept Gastroenterol, 1313-1 Koshiroukubo, Ina, Nagano 3968555, Japan
[8] Japanese Red Cross Soc Suwa Hosp, Dept Gastroenterol, 5-11-50 Kogandori, Suwa, Nagano 3928510, Japan
[9] Nagano Chuo Hosp, Dept Gastroenterol, 1570 Tsuruga Nishitsurugamachi, Nagano, Nagano 3800814, Japan
[10] Chikuma Cent Hosp, Dept Gastroenterol, 58 Kuiseshita, Chikuma, Nagano 3870011, Japan
[11] Japanese Red Cross Soc Azumino Hosp, Dept Gastroenterol, 5685 Toyoshina, Azumino, Nagano 3998205, Japan
[12] Aki Naika Clin, 236-1 Nozawa, Saku, Nagano 3850053, Japan
[13] Kawanakajima Clin, 1942-25 Kawanagajima Machi, Nagano, Nagano 3812221, Japan
[14] Gibo Hepatol Clin, 1-34-20 Muraimachiminami, Matsumoto, Nagano 3990036, Japan
[15] Kenwakai Hosp, Dept Gastroenterol, 1936 Kanaenakadaira, Iida, Nagano 3958522, Japan
[16] Kanebako Internal Med Clin, 320-2 Kanebako, Nagano, Nagano 3810007, Japan
[17] Nakano Gastroenterol Clin, 4-13-5 Muraimachiminami, Matsumoto, Nagano 3990036, Japan
[18] Aizawa Hosp, Gastroenterol Ctr, 2-5-1 Honjo, Matsumoto, Nagano 3900814, Japan
[19] Shinshu Univ, Dept Community Med Promot, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan
[20] Shinshu Univ, Inst Biomed Sci, Dept Life Innovat, 3-1-1 Asahi, Matsumoto, Nagano 3908621, Japan
基金
日本学术振兴会;
关键词
chronic hepatitis C; hepatitis C virus; glecaprevir; pibrentasvir; retreatment; HEPATOCELLULAR-CARCINOMA; NATURAL-HISTORY; LIVER-BIOPSY; GENOTYPE; HCV; FIBROSIS;
D O I
10.3390/biomedicines8040074
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Glecaprevir/pibrentasvir (G/P) are direct-acting antivirals (DAAs) that achieve a high sustained virological response (SVR) rate for hepatitis C virus (HCV) infection. We investigated G/P effectiveness for HCV patients based on real-world experience and the clinical features of retreatment cases. HCV patients (n = 182) were compared for clinical features and outcomes between first treatment (n = 159) and retreatment (n = 23) G/P groups. Overall, 77 patients (42.3%) were male, the median age was 68 years, and 86/66/1/4 cases had genotype 1/2/1 + 2/3, respectively. An SVR was achieved in 97.8% (178/182) of cases by intention-to-treat analysis and 99.4% (178/179) of cases by per-protocol analysis. There were no remarkable differences between the first treatment and retreatment groups for male (42.8% vs. 39.1%, p = 0.70), median age (68 vs. 68 years, p = 0.36), prior hepatocellular carcinoma (5.8% vs. 8.7%, p = 0.59), or the fibrosis markers AST-to-platelet ratio index (APRI) (0.5 vs. 0.5, p = 0.80) and fibrosis-4 (FIB-4) index (2.2 vs. 2.6, p = 0.59). The retreatment group had a significantly more frequent history of interferon treatment (12.3% vs. 52.2%, p < 0.01) and the Y93H mutation (25.0% vs. 64.7%, p = 0.02). The number of retreatment patients who had experienced 3, 2, and 1 DAA treatment failures was 1, 3, and 19, respectively, all of whom ultimately achieved an SVR by G/P treatment. In conclusion, G/P was effective and safe for both HCV first treatment and retreatment cases despite the retreatment group having specific resistance mutations for other prior DAAs. As G/P treatment failure has been reported for P32 deletions, clinicians should consider resistance mutations during DAA selection.
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页数:11
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