Direct-acting Antiviral Agents For Treatment Research Articles

Noninvasive Fibrosis Assessment in Chronic Hepatitis C Infection: An Update.

Liver biopsy is historically the gold standard for liver fibrosis assessment of chronic hepatitis C patients. However, with the introduction and validation of noninvasive tests (NITs) to evaluate advanced fibrosis, and the direct-acting antiviral agents for treatment of chronic hepatitis C virus (HCV), the role of NITs have become even more complex. There is now need for longitudinal monitoring and elucidation of cutoff values for prediction of liver-related complication after sustained virological response. The aim of this report is to provide a critical overview of the various NITs available for the assessment of liver fibrosis in HCV patients.

Clinical effect of direct-acting antiviral agents in treatment of chronic hepatitis C patients with thrombocytopenia

Clinical effect of direct-acting antiviral agents in treatment of chronic hepatitis C patients with thrombocytopenia

Antiviral Activity of Chitosan Nanoparticles Encapsulating Curcumin Against Hepatitis C Virus Genotype4a in Human Hepatoma Cell Lines.

PurposeCurrent direct-acting antiviral agents for treatment of hepatitis C virus genotype 4a (HCV-4a) have been reported to cause adverse effects, and therefore less toxic antivirals are needed. This study investigated the role of curcumin chitosan (CuCs) nanocomposite as a potential anti-HCV-4a agent in human hepatoma cells Huh7.MethodsDocking of curcumin and CuCs nanocomposite and binding energy calculations were carried out. Chitosan nanoparticles (CsNPs) and CuCs nanocomposite were prepared with an ionic gelation method and characterized with TEM, zeta size and potential, and HPLC to calculate encapsulation efficiency. Cytotoxicity studies were performed on Huh7 cells using MTT assay and confirmed with cellular and molecular assays. Anti-HCV-4a activity was determined using real-time PCR and Western blot.ResultsThe strength of binding interactions between protein ligand complexes gave scores with NS3 protease, NS5A polymerase, and NS5B polymerase of -124.91, -159.02, and -129.16, for curcumin respectively, and -68.51, -54.52, and -157.63 for CuCs nanocomposite, respectively. CuCs nanocomposite was prepared at sizes 29–39.5 nm and charges of 33 mV. HPLC detected 4% of curcumin encapsulated into CsNPs. IC50 was 8 µg/mL for curcumin and 25 µg/mL for the nanocomposite on Huh7 but was 25.8 µg/mL and 34 µg/mL on WISH cells. CsNPs had no cytotoxic effect on tested cell lines. Apoptotic genes’ expression revealed the caspase-dependent pathway mechanism. CsNPs and CuCs nanocomposite demonstrated 100% inhibition of viral entry and replication, which was confirmed with HCV core protein expression.ConclusionCuCs nanocomposite inhibited HCV-4a entry and replication compared to curcumin alone, suggesting its potential role as an effective therapeutic agent.

Thyroid in patients receiving new direct-acting antiviral agents for treatment of hepatitis C virus

Objective The aim was to judge thyroid dysfunction in patients receiving new direct-acting antiviral agents (DAAs) for treatment of hepatitis C pathogen. Background Persistent hepatitis C is a gradually progressive disease. DAAs provide high sustained viral response rates and much reduced adverse effects and impaired health-related quality of life during treatment. Patients and methods The analysis included 100 patients with persistent hepatitis C contamination with normal thyroid functions before starting treatment with DAAs. After obtaining written informed consent, all patients were analyzed and clinically assessed. Laboratory investigations including complete blood picture, assessment of liver organ and kidney function, thyroid-stimulating hormone, and free thyroxin 4 were done for all patients before the start of the remedy, and by the end of treatment of direct-acting antiviral remedy. Results An evaluation of the analyzed patients who were obtaining direct-acting antiviral drugs for treatment of hepatitis C pathogen before and after remedy with respect to the PCR findings proved significant decrease of PCR values after treatment (P = 0.0001). There is no statistically significant difference before and after remedy with new DAA regarding laboratory findings as serum thyroid-stimulating hormone (P = 0.580) and serum free T4 (P = 0.279). Conclusion Thyroid function in patients with chronic hepatitis C infection was not afflicted with treatment with new direct-acting antiviral drugs for treatment of hepatitis C virus.

Effectiveness and safety of direct-acting antiviral agents for treatment of patients with chronic hepatitis C virus infection

Hepatitis C is one of the major causes of liver disease worldwide. Chronic hepatitis C can cause liver fibrosis and cirrhosis leading to end-stage liver disease. Antiviral therapy can clear the virus, stop the progress of the disease, thereby reducing the incidence of advanced liver disease. This article aims to discuss the effects and safety of antiviral treatments, including direct- acting antiviral agents, on patients with chronic hepatitis C with fibrosis and compensated and decompensated liver cirrhosis.

Adverse effects, drug interactions, and safety of direct-acting antiviral agents in treatment of hepatitis C

Adverse effects, drug interactions, and safety of direct-acting antiviral agents in treatment of hepatitis C

New Oral Direct-Acting Antiviral Agents for Treatment of Chronic Hepatitis-C Infection in Patients with Chronic Kidney Disease Including Dialysis Patients and Kidney Transplant Recipients

New Oral Direct-Acting Antiviral Agents for Treatment of Chronic Hepatitis-C Infection in Patients with Chronic Kidney Disease Including Dialysis Patients and Kidney Transplant Recipients

Safety and Effectiveness of Direct-Acting Antiviral Agents for Treatment of Patients With Chronic Hepatitis C Virus Infection and Cirrhosis.

Direct-acting antivirals (DAAs) have revolutionized treatment for patients with chronic hepatitis C virus (HCV) infection, leading to a high rates of sustained virologic response. This study assessed the real-world safety and effectiveness of DAA-based antiviral therapy for the treatment of cirrhotic patients with chronic HCV infection. This international, multicenter cohort study included all consecutive patients with chronic HCV infection and cirrhosis who underwent antiviral therapy with second-generation DAAs. Data on all patients were analyzed to assess treatment response. Predictors of hepatic decompensation during antiviral therapy were assessed using Cox proportional hazards regression analyses. Until June 2015, 433 cirrhotic patients with chronic HCV infection started DAA-based treatment. Their mean age was 57.8 (±8.7) years, 277 (64.0%) patients were male, and 114 (26.3%) had a Child-Pugh (CP) score of B/C cirrhosis. The sustained virologic response rate at 12 weeks was similar among patients with a CP score of A (261 of 304 [85.9%]) and a CP score of B/C (83 of 101 [82.2%]; P= .37). A baseline albumin level less than 35 g/L (hazard ratio [HR], 3.11; 95% confidence interval [CI], 1.23-7.84; P= .005), baseline MELD score of 14 or higher (HR, 1.63; 95% CI, 1.03-2.61; P= .037), and HCV genotype 3 (HR, 2.05; 95% CI, 1.09-3.88; P= .033) were associated independently with hepatic decompensation during antiviral treatment among patients with a CP score of B/C. This large cohort study showed that therapy is safe and effective in patients with compensated (CP score of A) cirrhosis. For patients with decompensated (CP score of B/C) cirrhosis, albumin level less than 35 g/L, MELD score of 14 or greater, and HCV genotype 3 are important risk factors for hepatic decompensation during DAA-based treatment. Therefore, these patients require close monitoring during antiviral therapy or treatment should be deferred until after transplantation.

Clinical efficacy of direct-acting antiviral agents in treatment of patients with hepatitis C recurrence after liver transplantation

Clinical efficacy of direct-acting antiviral agents in treatment of patients with hepatitis C recurrence after liver transplantation