High rates of sustained virological response despite premature discontinuation of directly acting antivirals in HCV‐infected patients treated in a real‐life setting. Issue 3 (2nd January 2021)

• Record Type: Journal Article
• Authors: Fabbiani, Massimiliano; Lombardi, Andrea; Colaneri, Marta; Del Poggio, Paolo; Perini, Paolo; D'Ambrosio, Roberta; Degasperi, Elisabetta; Dibenedetto, Clara; Giorgini, Alessia; Pasulo, Luisa; Maggiolo, Franco; Castelli, Francesco; Brambilla, Paola; Spinelli, Ombretta; Re, Tiziana; Lleo, Ana; Rumi, Mariagrazia; Uberti‐Foppa, Caterina; Soria, Alessandro; Aghemo, Alessio; Lampertico, Pietro; Baiguera, Chiara; Schiavini, Monica; Fagiuoli, Stefano; Bruno, Raffaele
• Other Names: Borghi Marta investigator.; Soffredini Roberta investigator.; Perbellini Riccardo investigator.; Gori Andrea investigator.; Ferroni Valentina investigator.; Colpani Maria investigator.; Manini Matteo investigator.; Cologni Giuliana investigator.; Lazzaroni Sergio investigator.; Vinci Maria investigator.; De Nicola Stella investigator.; Mazzarelli Chiara investigator.; Angelini Zucchetti Teresa investigator.; Picciotto Viviana investigator.; Puoti Massimo investigator.; Rossotti Roberto investigator.; Landonio Simona investigator.; Magni Carlo Federico investigator.; Rizzardini Giuliano investigator.; Colella Elisa investigator.; Columpsi Paola investigator.; Gambaro Alessandra investigator.; Spolti Anna investigator.; Magnani Carlo investigator.; Viganò Paolo investigator.; Mena Maurizio investigator.; Villa Massimo investigator.; Caramma Ilaria investigator.; Basilico Cristina investigator.; Capelli Francesca investigator.; Biagiotti Sara investigator.; Mazzone Antonino investigator.; Saladino Valeria investigator.; Baldacci Maria Pia investigator.; Gatti Federico investigator.; Varalli Luca investigator.; Morini Lorenzo investigator.; Menzaghi Barbara investigator.; Farinazzo Maddalena investigator.; Meli Rossella investigator.; Plaz Torres Maria Corina investigator.; Rumi Mariagrazia investigator.; Fanetti Ilaria investigator.; Dibenedetto Clara investigator.; Orellana Daniel investigator.; Zermiani Paola investigator.; Zuin Massimo investigator.; De Bona Anna investigator.; D'Arminio Monforte Antonella investigator.; Capretti Andrea investigator.; Taddei Maria Teresa investigator.; Soncini Marco investigator.; Spinetti Angiola investigator.; Zaltron Stefania investigator.; Pigozzi Marie Graciella investigator.; Rossini Angelo investigator.; Pan Angelo investigator.; Dal Zoppo Sarah investigator.; Zoncada Alessia investigator.; Memoli Massimo investigator.; Salpietro Stefania investigator.; Hamid Hasson investigator.; Messina Emanuela investigator.; Colombo Alberto Eraldo investigator.; Giglio Omar investigator.; Bonfanti Paolo investigator.; Molteni Chiara investigator.; Terreni Natalia investigator.; Spinzi Giancarlo investigator.; Conforti Simone investigator.; Clerici Elisabetta investigator.; Menozzi Fernanda investigator.; Buscarini Elisabetta investigator.; Centenaro Riccardo investigator.; Corbellini Ada investigator.; Noventa Franco investigator.; Gritti Sara investigator.; Giani Pietro investigator.;
• Is Part Of: Journal of viral hepatitis. Volume 28:Issue 3(2021)
• Page Start: 558
• Page End: 568
• Publication Date: 2021-01-02
• Subjects: antiviral treatment -- chronic hepatitis C -- DAA -- liver cirrhosis -- SVR; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.13454
• Languages: English
• ISSNs: 1352-0504

Abstract

Abstract: In routine clinical practice, hepatitis C virus‐infected patients can prematurely discontinue the prescribed regimen for several reasons. The aim of our study was to investigate sustained virological response (SVR12) rates in patients who prematurely discontinued directly acting antiviral (DAA) regimens and to assess the shortest effective duration of DAA able to lead to SVR12. We retrospectively collected the SVR rates of patients, registered in the NAVIGATORE‐Lombardia Network database from January 2015, who discontinued DAAs before the predefined end of treatment. Overall, we included 365 patients, males were the majority (213, 58.4%), mean age was 60.5 years, and 53 (14.5%) patients were HIV‐co‐infected. Liver cirrhosis was observed in 251 (68.8%) subjects, and the most represented genotypes were 1b ( n = 168, 46%) and 3 ( n = 59, 16.2%). DAA was discontinued a median of 1 (IQR 1–4) weeks before the predefined EOT, with 164 (44.9%) patients stopping DAAs at least 2 weeks before the planned schedule. In patients with F0–F3 liver fibrosis, lower rates of SVR12 were observed in patients treated for <4 weeks: 50% ( n = 2/4) vs. 99.1% ( n = 109/110) for ≥4 weeks, p = 0.003. In patients with liver cirrhosis, lower rates of SVR12 were observed in patients treated <8 weeks: 83.3% ( n = 25/30) vs. 94.6% ( n = 209/221) for ≥8 weeks, p = 0.038. Despite premature discontinuation of DAA, high SVR12 rates were observed in a real‐life setting for treatment lasting at least 4 weeks in patients with liver fibrosis F0–F3 and 8 weeks in those with liver cirrhosis. On this basis, feasibility of reducing DAA treatment duration should be explored in randomized clinical trials.