Search results for "Direct-acting antiviral"

showing 10 items of 24 documents

Hepatic decompensation is the major driver of death in HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma

2017

Background & Aims Assessment of long-term outcome is required in hepatitis C virus (HCV)-infected patients with cirrhosis, who have been successfully treated for Barcelona Clinic Liver Cancer (BCLC) stage A hepatocellular carcinoma (HCC). However, problems arise due to the lack of models accounting for early changes during follow-up. The aim of this study was to estimate the impact of early events (HCC recurrence or hepatic decompensation within 12Â months of complete radiological response) on 5-year overall survival (OS) in a large cohort of patients with HCV and cirrhosis, successfully treated HCC. Methods A total of 328 consecutive Caucasian patients with HCV-related cirrhosis and BC…

Liver CirrhosisMaleHepatocellular Carcinoma Liver Cirrhosis hepatitis C virus Survival direct-acting antiviral agentsSurvival rateCirrhosisAntiviral agentGastroenterologyLiver cirrhosi0302 clinical medicineRecurrenceHepatic decompensation; Hepatitis C Virus (HCV); Hepatocellular carcinoma (HCC); Prognosis; Recurrences; Sustained virological response (SVR); overall survival (OS)Overall survivalLiver NeoplasmsHepatitis Coverall survival (OS)Middle AgedPrognosisHepatitis CSustained virological responseLocal030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemaleAntiviral agents; Carcinoma hepatocellular; Hepatic decompensation; Hepatitis C; Hepatocellular carcinoma (HCC); Liver cirrhosis; Overall survival; Prognosis; Recurrences; Survival rate; Sustained virological response; Aged; Carcinoma Hepatocellular; Female; Hepatitis C; Humans; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence Local; Proportional Hazards ModelsLiver cancerHepatic decompensationmedicine.medical_specialtyCarcinoma HepatocellularPrognosiSettore MED/12 - GASTROENTEROLOGIA03 medical and health scienceshepatocellularInternal medicinemedicineEarly Hepatocellular CarcinomaHumansRecurrencesHepatocellular carcinoma (HCC)Survival rateAntiviral agents; Carcinoma hepatocellular; Hepatic decompensation; Hepatitis C; Hepatocellular carcinoma (HCC); Liver cirrhosis; Overall survival; Prognosis; Recurrences; Survival rate; Sustained virological response; HepatologyAgedProportional Hazards ModelsHepatologybusiness.industryHepatitis C Virus (HCV)CarcinomaHepatocellularHepatologymedicine.diseasedigestive system diseasesNeoplasm RecurrenceAntiviral agentsLiver cirrhosisLiver functionNeoplasm Recurrence LocalbusinessSustained virological response (SVR)
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Executive summary of the 2018 KDIGO Hepatitis C in CKD Guideline: welcoming advances in evaluation and management

2018

Infection with the hepatitis C virus (HCV) has adverse liver, kidney, and cardiovascular consequences in patients with chronic kidney disease (CKD), including those on dialysis therapy and in those with a kidney transplant. Since the publication of the original Kidney Disease: Improving Global Outcomes (KDIGO) HCV Guideline in 2008, major advances in HCV management, particularly with the advent of direct-acting antiviral therapies, have now made the cure of HCV possible in CKD patients. In addition, diagnostic techniques have evolved to enable the noninvasive diagnosis of liver fibrosis. Therefore, the Work Group undertook a comprehensive review and update of the KDIGO HCV in CKD Guideline.…

Liver Cirrhosishepatitis C virusmedicine.medical_treatment030232 urology & nephrologylcsh:RC870-923medicine.disease_causecryoglobulinemialiver testingantivirals0302 clinical medicinesystematic reviewMedicineInfection controlKidney transplantationKDIGOCross Infectionhemodialysisnosocomial transmissionvirus diseasesHepatitis CHepatitis Cinfection controlNephrologyPractice Guidelines as Topic030211 gastroenterology & hepatologyHemodialysisguidelineGlomerular Filtration Ratemedicine.medical_specialtyHepatitis C viruskidney transplantationAntiviral Agents03 medical and health sciencesRenal DialysisDisease Transmission InfectiousHumansRenal Insufficiency ChronicIntensive care medicineglomerular diseasesdirect-acting antiviralsDialysisbusiness.industryscreeningGuidelinelcsh:Diseases of the genitourinary system. Urologymedicine.diseaseKidney Transplantationdialysisbusinesschronic kidney diseaseKidney diseaseKidney International
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Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies

2017

Background & Aims: Despite the excellent efficacy of direct-acting antivirals (DAA) reported in clinical trials, virological failures can occur, often associated with the development of resistance-associated substitutions (RASs). This study aimed to characterize the presence of clinically relevant RASs to all classes in real-life DAA failures. Methods: Of the 200 virological failures that were analyzed in 197 DAA-treated patients, 89 with pegylated-interferon+ribavirin (PegIFN+RBV) and 111 without (HCV-1a/1b/1g/2/3/4=58/83/1/6/24/25; 56.8% treatment experienced; 65.5% cirrhotic) were observed. Sanger sequencing of NS3/NS5A/NS5B was performed by home-made protocols, at failure (N= 200) and w…

Male0301 basic medicinehepatitis C virusSustained Virologic ResponseSofosbuvirHepacivirusDrug ResistanceHepacivirusresistance-associated substitutionsViral Nonstructural ProteinsVARIANTSNS5Amedicine.disease_causeGastroenterologychemistry.chemical_compound0302 clinical medicineRecurrenceINFECTIONantiviral therapyMedicinehepatitis C viruViralTreatment FailureChronicantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; hepatologybiologyGENOTYPE 1virus diseasesMiddle Agedantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutionsSettore MED/07 - Microbiologia e Microbiologia ClinicaHepatitis CItalyCombinationInterferonDrug Therapy CombinationFemale030211 gastroenterology & hepatologyAuthor Keywords:antiviral therapyRIBAVIRINSequence AnalysisHumanmedicine.drugmedicine.medical_specialtyDaclatasvirGenotypeHepatitis C virusAntiviral AgentsLONG-TERM PERSISTENCEDACLATASVIR03 medical and health sciencesDrug Therapyantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; Aged; Antiviral Agents; Drug Resistance Viral; Drug Therapy Combination; Female; Genotype; Hepacivirus; Hepatitis C Chronic; Humans; Interferons; Italy; Male; Middle Aged; Mutation; Recurrence; Ribavirin; Sequence Analysis DNA; Sofosbuvir; Sustained Virologic Response; Treatment Failure; Viral Nonstructural Proteins; HepatologyTREATMENT-NAIVEInternal medicineDrug Resistance ViralRibavirinHumansNS5Aresistance testdirect-acting antiviralsAgedAntiviral Agentresistance-associated substitutiondirect-acting antiviralHepaciviruHepatologyresistance test KeyWords Plus:HEPATITIS-C VIRUSbusiness.industryRibavirinViral Nonstructural ProteinSequence Analysis DNADNAHepatitis C ChronicHepatologybiology.organism_classificationClinical trial030104 developmental biologySOFOSBUVIRchemistrySequence AnalysihepatologyMutationImmunologyInterferonsSofosbuvirbusiness
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Direct-acting antivirals after successful treatment of early hepatocellular carcinoma improve survival in HCV-cirrhotic patients

2019

Background & Aims: The effectiveness of direct-acting antivirals (DAAs) against hepatitis C virus (HCV), following successful treatment of early hepatocellular carcinoma (HCC), has been studied extensively. However, the benefit in terms of overall survival (OS) remains to be conclusively demonstrated. The aim of this study was to assess the impact of DAAs on OS, HCC recurrence, and hepatic decompensation. Methods: We prospectively enrolled 163 consecutive patients with HCV-related cirrhosis and a first diagnosis of early Barcelona Clinic Liver Cancer stage 0/A HCC, who had achieved a complete radiologic response after curative resection or ablation and were subsequently treated with DAA…

Male0301 basic medicinemedicine.medical_specialtySurvival rateCarcinoma HepatocellularCirrhosisSustained Virologic ResponsePrognosiHepatitis C virus (HCV) Hepatocellular carcinoma (HCC) Direct-acting antiviral (DAA) Overall survival Prognosis Survival rate Liver cirrhosisHepacivirusAntiviral AgentsGastroenterologyLiver cirrhosi03 medical and health sciences0302 clinical medicineInternal medicinemedicineHumansEarly Hepatocellular CarcinomaOverall survivalProspective StudiesHepatocellular carcinoma (HCC)Propensity ScoreSurvival rateAgedAged 80 and overHepatologybusiness.industryLiver NeoplasmsHazard ratioDirect-acting antiviral (DAA)Hepatitis CHepatitis C virus (HCV)Middle Agedmedicine.diseasePrognosisHepatitis CDirect-acting antiviral (DAA); Hepatitis C virus (HCV); Hepatocellular carcinoma (HCC); Liver cirrhosis; Overall survival; Prognosis; Survival rate030104 developmental biologyHepatocellular carcinomaLiver cirrhosisFemale030211 gastroenterology & hepatologyNeoplasm Recurrence LocalLiver cancerbusinessViral hepatitisFollow-Up Studies
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Characteristics of patients with hepatitis C virus-related chronic liver diseases just before the era of oral direct-acting antiviral therapy in Italy

2018

Background In 2017, oral direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection became available free of charge for all HCV-RNA-positive patients, irrespective of their fibrosis stage. Aim The aim of this study was to evaluate the characteristics of HCV-related chronic liver disease (CLD) in Italy just before the introduction of DAA therapy. Patients and methods Patients with CLD were enrolled in two national surveys conducted in 2001 and in 2014. The two surveys prospectively enrolled patients aged older than 18 years referring to Italian liver units throughout the country using a similar clinical approach and analytical methods. Results Out of the 12 564 patie…

MaleCirrhosisTime FactorsAdministration OralHepacivirusmedicine.disease_causeChronic liver diseaseSeverity of Illness Index0302 clinical medicineRisk FactorsOdds RatioPrevalenceMedicine030212 general & internal medicineProspective StudiesMultivariate AnalysiGastroenterologyHealth SurveyMiddle AgedViral LoadItalyRNA Viral030211 gastroenterology & hepatologyFemaleHumanAdultmedicine.medical_specialtyLogistic ModelTime FactorGenotypeHepatitis C virusAntiviral AgentsVirus03 medical and health sciencesAge DistributionInternal medicinechronic hepatitis CHumansSex DistributionProtective FactorAgedAntiviral AgentCross-Sectional StudieHepatitis B virusHepaciviruChi-Square DistributionHepatologybusiness.industryRisk Factorchronic liver diseaseBiomarkerOdds ratioHepatitis C AntibodiesHepatitis C ChronicProtective Factorsmedicine.diseaseHealth SurveysConfidence intervaldirect-acting antiviral therapyProspective Studiehepatitis infectionCross-Sectional StudiesLogistic ModelsMultivariate AnalysisEtiologyHepatitis C AntibodiebusinessBiomarkers
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Delisting HCV-infected liver transplant candidates who improved after viral eradication: Outcome 2 years after delisting

2018

International audience; BACKGROUNDS & AIMS: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. METHODS: One hundred and forty-two HCV-positive patients on the liver transplant waiti…

MaleLiver Cirrhosismedicine.medical_specialtyCirrhosisCarcinoma HepatocellularWaiting Listsmedicine.medical_treatment[SDV]Life Sciences [q-bio]Liver transplantationSeverity of Illness IndexAntiviral Agents03 medical and health sciences0302 clinical medicineInternal medicineAscitesmedicineHumansDecompensationChronicdirect-acting antiviralsdirect-acting antiviralHepatologyliver transplantationbusiness.industrydelistingcirrhosisCarcinomaLiver NeoplasmsHepatocellularHepatitis CTransplant Waiting ListHepatitis C ChronicMiddle Agedmedicine.diseaseHepatitis C3. Good healthItaly030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemaleLiver functionmedicine.symptombusinesscirrhosi
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Resistance analysis and treatment outcomes in hepatitis C virus genotype 3-infected patients within the Italian network VIRONET-C

2021

Aim: This study aimed to investigate the role of resistance-associated substitutions (RASs) to direct-acting-antivirals (DAAs) in HCV genotype 3 (GT3). Methods: Within the Italian VIRONET-C network, a total of 539 GT3-infected patients (417 DAA-naïve and 135 DAA-failures, of them, 13 at both baseline and failure) were analysed. Sanger sequencing of NS3/NS5A/NS5B was performed following home-made protocols. Results: The majority of patients were male (79.4%), 91.4% were injection drug users, 49.3% were cirrhotic and 13.9% were HIV co-infected. Phylogenetic analysis classified sequences as GT3a-b-g-h (98%-0.4%-0.2%-1.2%) respectively. Overall, 135 patients failed a DAA regimen: sofosbuvir (SO…

MaleSofosbuvirSustained Virologic ResponseDrug ResistanceHepacivirusViral Nonstructural ProteinsGastroenterologySettore MED/06direct-acting antivirals; failure; genotype 3; HCV; resistancechemistry.chemical_compound0302 clinical medicineMedicineViralChronicPhylogenyDasabuvirdirect-acting antivirals; failure; genotype 3; hcv; resistancevirus diseasesHepatitis CPibrentasvirfailureItaly030220 oncology & carcinogenesisHCVCombinationDrug Therapy Combination030211 gastroenterology & hepatologyFemalemedicine.drugLedipasvirmedicine.medical_specialtyDaclatasvirGenotypedirect-acting antivirals; failure; genotype 3; HCV; resistance; Antiviral Agents; Drug Resistance Viral; Drug Therapy Combination; Female; Genotype; Humans; Italy; Male; Phylogeny; Sofosbuvir; Sustained Virologic Response; Viral Nonstructural Proteins; Hepacivirus; Hepatitis C ChronicAntiviral Agentsresistance03 medical and health sciencesDrug TherapyInternal medicineDrug Resistance ViralHumansgenotype 3direct-acting antiviralsAntiviral Agentdirect-acting antiviralHepaciviruHepatologybusiness.industryViral Nonstructural ProteinGlecaprevirHepatitis C ChronicHCV; direct acting antivirals; failure; genotype 3; resistanceRegimenchemistryParitaprevirSofosbuvirbusinessHepatitis C Chronic.
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HCV cirrhosis at the edge of decompensation: Will paritaprevir with ritonavir, ombitasvir, dasabuvir, and ribavirin solve the need for treatment?

2014

BACKGROUND: The interferon-free combination of the protease inhibitor ABT-450 with ritonavir (ABT-450/r) and the NS5A inhibitor ombitasvir (also known as ABT-267) plus the nonnucleoside polymerase inhibitor dasabuvir (also known as ABT-333) and ribavirin has shown efficacy against the hepatitis C virus (HCV) in patients with HCV genotype 1 infection. In this phase 3 trial, we evaluated this regimen in previously untreated patients with HCV genotype 1 infection and no cirrhosis. METHODS: In this multicenter, randomized, double-blind, placebocontrolled trial, we assigned previously untreated patients with HCV genotype 1 infection, in a 3:1 ratio, to an active regimen consisting of a single-ta…

Malemedicine.medical_specialtyMacrocyclic CompoundsDirect-acting antiviralsLiver functionGastroenterologyAntiviral Agents03 medical and health scienceschemistry.chemical_compound0302 clinical medicinePegylated interferonInternal medicineRibavirinmedicineHumansAnilidesPortal hypertensionUracilAdvanced liver diseaseSulfonamidesDasabuvirRitonavirHepatologybusiness.industryRibavirinvirus diseasesHepatitis C ChronicVirologyOmbitasvir3. Good healthRegimenchemistryParitaprevir030220 oncology & carcinogenesis030211 gastroenterology & hepatologyRitonavirFemaleLiver functionCarbamatesbusinessmedicine.drugJournal of Hepatology
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Direct-acting antiviral agents and risk of Hepatocellular carcinoma: Critical appraisal of the evidence

2021

Direct-acting antivirals (DAAs) revolutionized the treatment of chronic HCV-related disease achieving high rates of sustained virological response (SVR), even in advanced cirrhosis, with modest contraindications and a low rate of adverse events. However, the risk of hepatocellular carcinoma (HCC) persists due to the underlying chronic liver disease, both in patients with and without history of HCC. Although some initial studies reported a presumptive high risk of HCC development after DAA therapy, more recent observational studies denied this hypothesis. The residual risk for HCC occurrence after HCV eradication seems being progressively reduced with time after SVR. Data on recurrence of HC…

Oncologymedicine.medical_specialtyCarcinoma HepatocellularSustained Virologic ResponseSurvivalHepatocellular carcinomaHepatitis C virusSpecialties of internal medicineDiseaseDirect-acting antiviralsDirect-acting antiviralmedicine.disease_causeChronic liver diseaseAntiviral AgentsRecurrenceInternal medicineCarcinomaHumansMedicineAdverse effectRetrospective StudiesHepatologyHepatitis C virusbusiness.industryLiver NeoplasmsGeneral MedicineHepatitis C Chronicmedicine.diseasedigestive system diseasesResidual riskRC581-951Hepatocellular carcinomaObservational studyHepatitis C virubusinessAnnals of Hepatology
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Effects of direct-acting antiviral therapy (DAAS) on the ultrasound parameters of portal hypertension

2018

Background:Among the endpoints of antiviral therapy with DAAs in HCV related liver cirrhosis (LC-HCV) in addition to the eradication of the virus there are the regression of fibrosis and of portal hypertension. For this reason we evaluated in LC-HCV patients and sustained virological response (SVR) to DAAs therapy the behavior of the AST to Platelet Ratio Index (APRI) (indirect marker of fibrosis) and of two ultrasound (US) signs of portal hypertension: caliber of the portal vein (cPV ) and longitudinal diameter of the spleen (LDS) Methods:132 patients with LC-HCV at baseline (BL), at three months (PostT3) and 12 months (PostT12) after the end of therapy, performed liver function tests and …

Settore MED/09 - Medicina InternaDirect-acting antiviral therapy DAAs ultrasound parameters portal hypertension
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