Direct-Acting Antiviral Use for Genotype 1b Hepatitis C Patients with Associated Hematological Disorders from Romania.

Iosif Marincu,Bianca Cerbu,Manuela Curescu,Oana Suciu,Felix Bratosin,Iulia Vidican,Mirela Turaiche

doi:10.3390/medicina57090986

Abstract

Background and objectives: this study assessed variations in the blood parameters of patients with hematological disorders infected with HCV throughout a 12-week interferon-free treatment regimen. Materials and methods: We followed a total of 344 patients suffering from chronic hepatitis C, infected with the 1b genotype and concomitant hematological disorders, who benefited from the direct-acting antiviral (DAA) therapy in our clinic. Seven of the most routinely checked blood parameters were analyzed, namely, hemoglobin, leucocyte count, neutrophils, erythrocyte count, platelet count, ALT, and total bilirubin level. In total, 129 patients received a treatment scheme comprising ombitasvir, paritaprevir, ritonavir, and dasabuvir, while the 215 other patients received a sofosbuvir and ledipasvir regimen. Results: Patients enrolled in the study showed remarkably increased ALT levels in the first four weeks of DAA treatment, normalizing to levels below 40 U/L by the end of regimen. There were no other blood parameters that worsened throughout the 12-week regimen to levels below our laboratory’s normal range. After 12 weeks of DAA therapy, 309 patients (90%) achieved SVR. Conclusions: Our findings are consistent in evaluating the efficacy and tolerability of direct-acting antivirals for 1b genotype HCV infected patients with associated hematological malignancies under remission, and other hematological disturbances, that were previously unsuccessfully treated with a pegylated interferon regimen. Thus, paving a pathway for government-funded programs being implemented in this direction.

Highlights

Chronic hepatitis C is a liver infection caused by the hepatitis C virus (HCV), an enveloped, single-stranded linear ribonucleic acid (RNA) virus of the Flaviviridae family with six major genotypes
According to a 2018 study [2], more than 380,000 Romanians suffer from chronic hepatitis C (CHC), placing the country among others in the top of the ranking list of European countries with the highest numbers of patients with CHC
Across the first two years of the study, patients received a treatment scheme consisting of Viekirax®® and Exviera®®

Summary

Introduction

Chronic hepatitis C is a liver infection caused by the hepatitis C virus (HCV), an enveloped, single-stranded linear ribonucleic acid (RNA) virus of the Flaviviridae family with six major genotypes. About 180 million people globally are chronically infected with the HCV [1]. The genotype 1b of the HCV is endemic to the European region, and the most prevalent in Romania [3]. The prevalence of genotype 1b in the general population reaches 4.9%, while in Romania, it is responsible for more than 50% of all HCV infections [4]. Chronic HCV is characterized by the persistence of HCV RNA in the blood for over six months after acute infection [5]. Around 54% to 86% of patients diagnosed with acute HCV infection develop a chronic illness [6]. With the disease’s progression, at least 20% of chronically infected individuals develop liver fibrosis and cirrhosis [7], while being at risk for life-threatening complications such as hepatocellular carcinoma and end-stage liver disease [8]

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Results

Conclusion