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Zarębska-Michaluk D, Flisiak R, Jaroszewicz J, Janczewska E, Czauż-Andrzejuk A, Berak H, Horban A, Staniaszek A, Gietka A, Tudrujek M, Tomasiewicz K, Dybowska D, Halota W, Piekarska A, Sitko M, Garlicki A, Orłowska I, Simon K, Belica-Wdowik T, Baka-Ćwierz B, Mazur W, Białkowska J, Socha Ł, Wawrzynowicz-Syczewska M, Laurans Ł, Deroń Z, Lorenc B, Dobracka B, Tronina O, Pawłowska M. Is Interferon-Based Treatment of Viral Hepatitis C Genotype 3 Infection Still of Value in the Era of Direct-Acting Antivirals? J Interferon Cytokine Res 2019; 38:93-100. [PMID: 29443655 DOI: 10.1089/jir.2017.0113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The aim of the study is to analyze treatments available for patients infected with genotype (G) 3 hepatitis C virus (HCV) in Poland at the beginning of the interferon (IFN)-free era and evaluate the efficacy and safety of different therapeutic options administered in a real-world setting. We analyzed data of 198 patients who started antiviral therapy after July 1, 2015, and completed it before December 31, 2016; 57.6% of them had liver cirrhosis and 46% were treatment experienced. Fifty percent of patients were assigned to sofosbuvir (SOF)+pegylated IFN alfa (PegIFNa)+ribavirin (RBV), 9% to PegIFNa+RBV, 36% received SOF+RBV, and 5% SOF+daclatasvir (DCV)±RBV. Cirrhotic patients were assigned more frequently to IFN-free regimens. Overall, a sustained virological response was achieved by 84.3% of patients in intent-to-treat (ITT) analysis and 87% in modified ITT analysis. For SOF+PegIFNa+RBV and SOF+DCV±RBV regimens, the sustained virologic response (SVR) rate reached at least 90%, whereas the two other therapeutic options demonstrated efficacy <80%. The SVR rate in noncirrhotics was higher than in cirrhotics, irrespective of regimen. Adverse events were documented in 52.5%, with the most common being weakness/fatigue and anemia. We confirmed effectiveness and safety of the SOF-based treatment in a real-world cohort of patients with chronic HCV G3 infection. Most notably, we demonstrated good tolerability and high efficacy of the SOF+PegIFNa+RBV regimen.
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Affiliation(s)
- Dorota Zarębska-Michaluk
- 1 Department of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University , Kielce, Poland
| | - Robert Flisiak
- 2 Department of Infectious Diseases and Hepatology, Medical University of Białystok , Białystok, Poland
| | - Jerzy Jaroszewicz
- 3 Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice , Bytom, Poland
| | | | - Agnieszka Czauż-Andrzejuk
- 2 Department of Infectious Diseases and Hepatology, Medical University of Białystok , Białystok, Poland
| | - Hanna Berak
- 5 Hospital for Infectious Diseases in Warsaw , Warsaw, Poland
| | - Andrzej Horban
- 5 Hospital for Infectious Diseases in Warsaw , Warsaw, Poland
| | - Agnieszka Staniaszek
- 6 Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration , Warsaw, Poland
| | - Andrzej Gietka
- 6 Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration , Warsaw, Poland
| | - Magdalena Tudrujek
- 7 Department of Infectious Diseases and Hepatology, Medical University of Lublin , Lublin, Poland
| | - Krzysztof Tomasiewicz
- 7 Department of Infectious Diseases and Hepatology, Medical University of Lublin , Lublin, Poland
| | - Dorota Dybowska
- 8 Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń , Bydgoszcz, Poland
| | - Waldemar Halota
- 8 Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń , Bydgoszcz, Poland
| | - Anna Piekarska
- 9 Department of Infectious Diseases and Hepatology, Medical University of Łódź , Łódź, Poland
| | - Marek Sitko
- 10 Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum , Kraków, Poland
| | - Aleksander Garlicki
- 10 Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum , Kraków, Poland
| | - Iwona Orłowska
- 11 Department of Infectious Diseases and Hepatology, Wrocław Medical University , Wrocław, Poland
| | - Krzysztof Simon
- 11 Department of Infectious Diseases and Hepatology, Wrocław Medical University , Wrocław, Poland
| | - Teresa Belica-Wdowik
- 12 Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology , John Paul II Hospital, Kraków, Poland
| | - Barbara Baka-Ćwierz
- 12 Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology , John Paul II Hospital, Kraków, Poland
| | - Włodzimierz Mazur
- 13 Clinical Department of Infectious Diseases, Specialist Hospital in Chorzów, Medical University of Silesia , Katowice, Chorzów, Poland
| | - Jolanta Białkowska
- 14 Department of Infectious and Liver Diseases, Medical University of Łódź , Łódź, Poland
| | - Łukasz Socha
- 15 Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University , Szczecin, Poland
| | - Marta Wawrzynowicz-Syczewska
- 15 Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University , Szczecin, Poland
| | - Łukasz Laurans
- 15 Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University , Szczecin, Poland .,16 Multidisciplinary Regional Hospital in Gorzów Wielkopolski , Gorzów Wielkopolski, Poland
| | - Zbigniew Deroń
- 17 Ward of Infectious Diseases and Hepatology, Biegański Regional Specialist Hospital , Łódź, Poland
| | - Beata Lorenc
- 18 Pomeranian Center of Infectious Diseases, Department of Infectious Diseases, Medical University of Gdańsk , Gdańsk, Poland
| | | | - Olga Tronina
- 20 Department of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw , Warsaw, Poland
| | - Małgorzata Pawłowska
- 8 Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń , Bydgoszcz, Poland
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Zarębska-Michaluk D, Jaroszewicz J, Janczewska E, Berak H, Horban A, Sitko M, Garlicki A, Dobracka B, Czauż-Andrzejuk A, Dybowska D, Halota W, Pawłowska M, Tudrujek-Zdunek M, Tomasiewicz K, Mazur W, Deroń Z, Belica-Wdowik T, Baka-Ćwierz B, Buczyńska I, Simon K, Piekarska A, Białkowska-Warzecha J, Lorenc B, Krygier R, Staniaszek A, Klapaczyński J, Citko J, Socha Ł, Wawrzynowicz-Syczewska M, Laurans Ł, Flisiak R. Interferon Free Therapy with and Without Ribavirin for Genotype 1 HCV Cirrhotic Patients in the Real World Experience. Hepat Mon 2018; 18. [DOI: 10.5812/hepatmon.80761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Flisiak R, Zarębska-Michaluk D, Janczewska E, Staniaszek A, Gietka A, Mazur W, Tudrujek M, Tomasiewicz K, Belica-Wdowik T, Baka-Ćwierz B, Dybowska D, Halota W, Lorenc B, Sitko M, Garlicki A, Berak H, Horban A, Orłowska I, Simon K, Socha Ł, Wawrzynowicz-Syczewska M, Jaroszewicz J, Deroń Z, Czauż-Andrzejuk A, Citko J, Krygier R, Piekarska A, Laurans Ł, Dobracki W, Białkowska J, Tronina O, Pawłowska M. Treatment of HCV infection in Poland at the beginning of the interferon-free era-the EpiTer-2 study. J Viral Hepat 2018; 25:661-669. [PMID: 29316039 DOI: 10.1111/jvh.12861] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023]
Abstract
The aim of the EpiTer-2 study was to analyse patient characteristics and their medication for HCV infection in Poland at the beginning of the interferon-free era. Analysis of data of HCV infected patients treated during the initial period of availability of interferon-free regimens in Poland, who started therapy after 1 July 2015 and had available an efficacy evaluation report before 30 June 2017 was undertaken. A total of 2879 patients with chronic hepatitis C were entered, including 46% with liver cirrhosis. The most common was genotype 1b (86.8%). The study population was gender balanced, the majority of patients were overweight or obese and 69% presented comorbidities, with the highest prevalence that for hypertension. More than half of patients were retreated due to failure of previous therapy with pegylated interferon and ribavirin. Almost two-third of patients received current therapy with ombitasvir/paritaprevir/ritonavir±dasabuvir (OPrD) ±ribavirin. Other patients received mostly sofosbuvir-based regimens including combination with ledipasvir and pegylated interferon and ribavirin for genotype 3-infected patients. Efficacy of treatment in the whole study population measured as intent-to-treat analysis was 95%. The most frequent regimen, administered for patients infected with genotype 1b, was 12 weeks of OPrD, resulting in an SVR rate of 98%. At least one adverse event was reported in 38% of patients, and the death rate was 0.8%. In conclusion, data from the EpiTer-2 study confirmed the excellent efficacy and safety profile of the real-world experience with recently introduced therapeutic options for genotype 1 HCV infection, but demonstrated weakness of the current therapeutic programme regarding genotype 3 infections.
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Affiliation(s)
- R Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - D Zarębska-Michaluk
- Department of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University, Kielce, Poland
| | - E Janczewska
- Hepatology Outpatient Clinic, ID Clinic, Mysłowice, Poland
| | - A Staniaszek
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - A Gietka
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - W Mazur
- Clinical Department of Infectious Diseases, Specialist Hospital in Chorzów, Medical University of Silesia, Katowice, Poland
| | - M Tudrujek
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, Poland
| | - K Tomasiewicz
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, Poland
| | - T Belica-Wdowik
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - B Baka-Ćwierz
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - D Dybowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
| | - W Halota
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
| | - B Lorenc
- Pomeranian Center of Infectious Diseases, Department of Infectious Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sitko
- Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - A Garlicki
- Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - H Berak
- Hospital for Infectious Diseases in Warsaw, Medical University in Warsaw, Warsaw, Poland
| | - A Horban
- Hospital for Infectious Diseases in Warsaw, Medical University in Warsaw, Warsaw, Poland
| | - I Orłowska
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, Warsaw, Poland
| | - K Simon
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, Warsaw, Poland
| | - Ł Socha
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Wawrzynowicz-Syczewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - J Jaroszewicz
- Department of Infectious Diseases, Medical University of Silesia in Katowice, Bytom, Poland
| | - Z Deroń
- Ward of Infectious Diseases and Hepatology, Biegański Regional Specialist Hospital, Łódź, Poland
| | - A Czauż-Andrzejuk
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - J Citko
- Medical Practice of Infections, Regional Hospital, Olsztyn, Poland
| | - R Krygier
- Infectious Diseases and Hepatology Outpatient Clinic NZOZ "Gemini", Żychlin, Poland
| | - A Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - Ł Laurans
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland.,Multidisciplinary Regional Hospital in Gorzów Wielkopolski, Gorzów Wielkopolski, Poland
| | | | - J Białkowska
- Department of Infectious and Liver Diseases, Medical University of Łódź, Łódź, Poland
| | - O Tronina
- Department of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - M Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
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