Search results for "Sustained virologic response"

showing 10 items of 45 documents

Effects of Eradicating Hepatitis C Virus Infection in Patients With Cirrhosis Differ With Stage of Portal Hypertension.

2016

Clearance of hepatitis C virus (HCV) via antiviral treatment changes the course of liver disease. We evaluated the benefit of sustained virologic response (SVR) in patients with HCV and cirrhosis without (stage 1) and with (stage 2) esophageal varices (EV).We performed a prospective cohort study of 444 patients with HCV and compensated cirrhosis (218 with stage 1 and 226 with stage 2 disease) treated with peg-interferon and ribavirin from June 2001 through December 2009 at the University of Palermo, Italy and followed for a median of 7.6 years (range, 1-12.6 years). We used Cox regression analysis to identify variables associated with appearance or progression of EVs, development of hepatoc…

Liver CirrhosisMaleCirrhosisSustained Virologic ResponseHepacivirusEsophaguGastroenterologyPolyethylene GlycolsLiver diseasechemistry.chemical_compound0302 clinical medicineEsophageal varicesProspective StudiesProspective cohort studyHazard ratioGastroenterologyvirus diseasesMiddle AgedPortal PressureHepatitis CRecombinant ProteinsIntention to Treat AnalysisItaly030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemalemedicine.medical_specialtyInterferon alpha-2Lower riskEsophageal and Gastric VaricesAntiviral Agents03 medical and health sciencesInternal medicineHypertension PortalRibavirinmedicineHumansAgedProportional Hazards ModelsHepatologybusiness.industryRibavirinBleedingInterferon-alphaLong-Term Outcomemedicine.diseasedigestive system diseaseschemistrybusinessFollow-Up StudiesGastroenterology
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Predictors of hepatocellular carcinoma in HCV cirrhotic patients treated with direct acting antivirals

2018

Background: Despite the dramatic improvement in viral eradication rates that has been reached with direct antiviral agents (DAAs),the real benefit of viral eradication after DAAs on hepatocellular carcinoma (HCC) development is still controversial. Aim: To prospectively assess the risk of HCC occurrence and early recurrence in a large cohort of DAAtreated HCV-cirrhotic patients and to identify potential predictors of HCC development. Methods: We analyzed data prospectively collected from 1927 consecutive HCV-infected cirrhotic patients treated with DAA from January to December 2015 in 10 tertiary liver centers in Italy and followed-up for one year after therapy. 161 patients had a previous …

Liver CirrhosisMaleCirrhosisSustained Virologic ResponseHepatocellular carcinomaDirect antiviral agentsDIRECT ACTING ANTIVIRALSGastroenterologyCohort Studies0302 clinical medicineRisk FactorsChronicIncidence (epidemiology)Liver NeoplasmsGastroenterologyMiddle AgedHepatitis CTumor recurrenceCirrhosis; Direct antiviral agents; HCV; Hepatocellular carcinoma; Aged; Antiviral Agents; Carcinoma Hepatocellular; Cohort Studies; Disease Progression; Female; Hepatitis C Chronic; Humans; Italy; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Neoplasm Recurrence Local; Risk Factors; alpha-Fetoproteins; Sustained Virologic ResponseItalyLocalCirrhosis030220 oncology & carcinogenesisHepatocellular carcinomaHCVDisease ProgressionPortal hypertension030211 gastroenterology & hepatologyFemalealpha-FetoproteinsCohort studymedicine.medical_specialtyCarcinoma HepatocellularEarly RecurrenceAntiviral Agents03 medical and health sciencesInternal medicinemedicineHumansneoplasmsAgedCirrhosiHepatologybusiness.industryCarcinomaHepatocellularHepatitis C Chronicmedicine.diseasedigestive system diseasesNeoplasm RecurrenceDirect antiviral agentNeoplasm Recurrence LocalCirrhosis; Direct antiviral agents; HCV; Hepatocellular carcinomabusiness
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Improved survival of patients with hepatocellular carcinoma and compensated hepatitis C virus-related cirrhosis who attained sustained virological re…

2017

Background Few studies examined the outcome of patients with hepatitis C virus (HCV)-related cirrhosis who developed hepatocellular carcinoma (HCC). The relative weight as determinant of death for cancer vs end-stage liver disease (ESLD) and the benefit of HCV eradication remain undefined. This multicentre, retrospective analysis evaluates overall survival (OS), rate of decompensation and tumour recurrence in compensated HCC patients treated with interferon (IFN) according to HCV status since HCC diagnosis. Methods Two groups of patients with HCV-related cirrhosis and HCC were followed since HCC diagnosis: (i) compensated cirrhotics with prior sustained virological response (SVR) on IFN-bas…

Liver CirrhosisMaleCirrhosisTime FactorsSustained Virologic ResponseHepacivirusKaplan-Meier Estimatemedicine.disease_causeGastroenterologyLiver disease0302 clinical medicineRisk Factorshepatitis C viruLiver Neoplasmsvirus diseasesHepatitis Chepatocellular carcinomainterferonMiddle AgedHepatitis CTreatment OutcomeItaly030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyDrug Therapy CombinationFemalesustained virological responseLiver cancermedicine.medical_specialtyCarcinoma HepatocellularHepatitis C virussurvivalAntiviral Agents03 medical and health sciencesInternal medicineRibavirinmedicinehepatitis C virus; hepatocellular carcinoma; interferon; survival; sustained virological response; HepatologyHumansDecompensationPropensity ScoreAgedProportional Hazards ModelsRetrospective StudiesHepatologybusiness.industryHepatologymedicine.diseasedigestive system diseasesMultivariate AnalysisInterferonsNeoplasm Recurrence LocalbusinessLiver international : official journal of the International Association for the Study of the Liver
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HCV genotype 1 subtypes (1a and 1b): similarities and differences in clinical features and therapeutic outcome.

2015

Aim: To evaluate similarities and differences in HCV-1 subtypes 1a and 1b in the presenting clinical features and the response to peg-interferon and ribavirin (Peg/RIBA).Patients and methods: A total of 1,233 naïve patients with HCV genotype-1 infection, 159 (13 %) with subtype 1a and 1,074 (87 %) with subtype 1b were treated with Peg-IFN/RIBA at 12 Italian centers. Covariates included in the logistic model were age, gender, BMI, serum alanine aminotransferase, serum gamma-glutamiltranspeptidase (γGT), platelets counts, liver fibrosis, the occurrence of type 2 diabetes, baseline viremia, and IL28B genotype.Results: At multivariate analysis, baseline characteristics differentiating patients …

Liver CirrhosisMaleMultivariate analysisclinical featuresChronic HCV liver diseaseType 2 diabetesSex FactorHepacivirusGastroenterologyPolyethylene GlycolPolyethylene Glycolstherapeutic outcomechemistry.chemical_compoundGenotypeAge FactorSettore MED/12 - GastroenterologiaSustained virologic responseAge Factorsvirus diseasesHCV genotype 1 subtypes (1a and 1b)Hepatitis CRecombinant ProteinMiddle AgedRecombinant ProteinsTreatment OutcomeInterferonRNA ViralFemaleHCV subtypeHumanAdultmedicine.medical_specialtyGenotypeLiver CirrhosiAlpha interferonmacromolecular substancesInterferon alpha-2Antiviral AgentsSex FactorsDiabetes mellitusInternal medicineRibavirinmedicineHumansPeg-interferon and ribavirinAntiviral AgentHepaciviruHepatologybusiness.industryRibavirinInterleukinstechnology industry and agricultureInterferon-alphaHepatologyInterleukinHepatitis C Chronicmedicine.diseaseVirologydigestive system diseaseschemistryDiabetes Mellitus Type 2HCV genotypeHCV genotype 1 subtypes (1a and 1b); clinical features; therapeutic outcomeInterferonshepatitis Cbusiness
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Role of IL-28B and inosine triphosphatase polymorphisms in efficacy and safety of Peg-Interferon and ribavirin in chronic hepatitis C compensated cir…

2013

Genetic factors can influence the outcome of antiviral therapy in chronic hepatitis C (HCV). We evaluated the role of interleukin-28B single nucleotide polymorphisms (SNPs) and inosine triphosphatase (ITPA) gene variants in HCV cirrhosis treated with Peg-Interferon and ribavirin. A prospective cohort of 233 patients with compensated cirrhosis received 1-1.5 μg/kg/week of Peg-Interferon alpha-2b plus 1000-1200 mg/day of RBV for 48 weeks. A sustained virologic response (SVR) was achieved in 27% of patients. On multivariate logistic analysis, the absence of oesophageal varices (OR 3.64 CI 95% 1.27-10.44 P = 0.016), infection with genotype 2 or 3 (OR 4.06, CI 95% 1.08-15.26, P = 0.038), C/C all…

Liver CirrhosisMaleSettore MED/07 - Microbiologia E Microbiologia ClinicaAnemia HemolyticGenotypeHepacivirusInterferon alpha-2Esophageal and Gastric VaricesAntiviral AgentsPolymorphism Single NucleotidePolyethylene GlycolsSettore BIO/13 - Biologia ApplicataRibavirinHumanschronic hepatitis C cirrhosis IL-28B inosine triphosphatase sustained virologic responseProspective StudiesPyrophosphatasesGenetic Association StudiesAgedSettore MED/12 - GastroenterologiaDose-Response Relationship DrugInterleukinsInterferon-alphaSequence Analysis DNAHepatitis C ChronicMiddle AgedRecombinant ProteinsLogistic ModelsTreatment OutcomeMultivariate AnalysisDrug Therapy CombinationFemaleInterferonsJournal of viral hepatitis
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High efficacy of direct-acting anti-viral agents in hepatitis C virus-infected cirrhotic patients with successfully treated hepatocellular carcinoma

2018

Background: The efficacy of direct-acting anti-viral (DAA) therapy in patients with a history of hepatocellular carcinoma (HCC) is unknown. Aim: We prospectively evaluated whether previously treated HCC affects DAA efficacy in a large real-life cohort of cirrhotic patients. Methods: From January to December 2015 all consecutive HCV mono-infected patients with cirrhosis and/or history of HCC attending 10 Italian tertiary liver centres were enrolled. Baseline characteristics and response to therapy were recorded. 1927 patients were enrolled (mean age: 62.1 10.9 years; 1.205 males). Genotype 1 was the most frequent (67.9%) followed by genotypes 3 (12.4%), 2 (11.2%) and 4 (8.6%). 88.4% and 10.9…

Liver CirrhosisMaleSimeprevirPyrrolidinesSustained Virologic ResponseSofosbuvirHepacivirusAged; Antiviral Agents; Benzimidazoles; Carcinoma Hepatocellular; Cohort Studies; Drug Therapy Combination; Female; Fluorenes; Genotype; Hepacivirus; Hepatic Encephalopathy; Hepatitis C Chronic; Humans; Imidazoles; Interferons; Italy; Liver Cirrhosis; Liver Neoplasms; Male; Middle Aged; Prospective Studies; Ribavirin; Simeprevir; Sofosbuvir; Sustained Virologic Response; Uridine Monophosphatemedicine.disease_causeGastroenterologyCohort Studieschemistry.chemical_compound0302 clinical medicineSimeprevirPharmacology (medical)Prospective Studies030212 general & internal medicineChronicLiver NeoplasmsImidazolesGastroenterologyValineHepatitis CMiddle AgedHepatitis CItalyHepatocellular carcinomaCombinationHCVDrug Therapy CombinationFemale030211 gastroenterology & hepatologyUridine Monophosphatemedicine.drugLedipasvirmedicine.medical_specialtyCarcinoma HepatocellularDaclatasvirGenotypeHepatitis C virusAntiviral Agents03 medical and health sciencesDrug TherapyInternal medicineRibavirinmedicineHumansAgedFluorenesHepatologybusiness.industryCarcinomaHepatocellularHepatitis C Chronicmedicine.diseasedigestive system diseasesRegimenchemistryHepatic EncephalopathyBenzimidazolesCarbamatesInterferonsSofosbuvirbusinessAlimentary Pharmacology & Therapeutics
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Dynamics of liver stiffness by transient elastography in patients with chronic hepatitis C virus infection receiving direct-acting antiviral therapy-…

2020

The impact of direct-acting antiviral (DAA) therapies on fibrosis regression remains uncertain. In the current study, we prospectively evaluated dynamics of liver stiffness by transient elastography (TE) in patients with chronic HCV infection receiving DAA-based treatment. Patients (260) were enrolled in the German Hepatitis C-Registry (DHC-R), a national multicentre real-world cohort. Liver stiffness (LS) was assessed at baseline, end of treatment (EOT) and 24 weeks after EOT (FU24) by TE. Biochemical, virological and clinical data were obtained in parallel. In patients with SVR, there was a significant improvement of LS between baseline (median [range], 8.6 [1.7-73.5] kPa) and FU24 (7.9 […

Liver Cirrhosismedicine.medical_specialtySustained Virologic ResponseBilirubinMedizinGastroenterologyAntiviral AgentsVirusTransaminase03 medical and health scienceschemistry.chemical_compound0302 clinical medicineFibrosisVirologyInternal medicineGermanymedicineHumans030212 general & internal medicineRegistriesHepatitisHepatologybusiness.industryHepatitis CHepatitis C Chronicmedicine.diseaseInfectious DiseasesTreatment OutcomechemistryLiverCohortElasticity Imaging Techniques030211 gastroenterology & hepatologybusinessTransient elastographyJournal of viral hepatitisREFERENCES
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Should organs from hepatitis C-positive donors be used in hepatitis C-negative recipients for liver transplantation?

2018

Given the scarcity of donated organs and the frequency of death on the waiting list, strategies that could improve the available supply of high-quality liver grafts are much needed. Direct-acting antiviral agent (DAA) regimens have proved to be highly effective to treat hepatitis C virus (HCV), even in the setting of posttransplantation. The question arises as to whether transplant communities should consider the utilization of HCV-positive donors into HCV-negative recipients. This review summarizes risk of transmission, treatment options with success rate, and ethical considerations for usage of HCV-positive donors. Liver Transplantation 24 831-840 2018 AASLD.

Liver surgerymedicine.medical_specialtySustained Virologic ResponseWaiting ListsHepatitis C virusmedicine.medical_treatmentMEDLINEHepacivirus030230 surgeryLiver transplantationmedicine.disease_causeAntiviral AgentsDonor SelectionEnd Stage Liver Disease03 medical and health sciences0302 clinical medicinemedicineHumansIntensive care medicineTransplantationHepatologybusiness.industryTransmission (medicine)Treatment optionsHepatitis Cmedicine.diseaseAllograftsHepatitis CTissue DonorsTransplant RecipientsLiver TransplantationLiverWaiting list030211 gastroenterology & hepatologySurgerybusinessLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
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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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