TY - JOUR
T1 - HCV clearance after direct-acting antivirals in patients with cirrhosis by stages of liver impairment
T2 - The ITAL-C network study
AU - Ippolito, Antonio Massimo
AU - Milella, Michele
AU - Messina, Vincenzo
AU - Conti, Fabio
AU - Cozzolongo, Raffaele
AU - Morisco, Filomena
AU - Brancaccio, Giuseppina
AU - Barone, Michele
AU - Santantonio, Teresa
AU - Masetti, Chiara
AU - Tundo, Paolo
AU - Smedile, Antonina
AU - Carretta, Vito
AU - Gatti, Pietro
AU - Termite, Antonio Patrizio
AU - Valvano, Maria Rosa
AU - Bruno, Giuseppe
AU - Fabrizio, Claudia
AU - Andreone, Pietro
AU - Zappimbulso, Marianna
AU - Gaeta, Giovanni Battista
AU - Napoli, Nicola
AU - Fontanella, Luca
AU - Lauletta, Gianfranco
AU - Cuccorese, Giuseppe
AU - Metrangolo, Antonio
AU - Francavilla, Ruggiero
AU - Ciracì, Emanuela
AU - Rizzo, Salvatore
AU - Andriulli, Angelo
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background Sustained virological response (SVR12) rates at 12 weeks after treatment for HCV-infected patients with decompensated cirrhosis are used when referring to those with moderate functional impairment, while few data are available for those with more severe impairment. The use of the cirrhosis staging system proposed by D'Amico might provide new insights on timing for antiviral therapy. Methods We investigated efficacy (SVR12), safety, and post-treatment variations in clinical and laboratory parameters in 2612 patients with advanced fibrosis (n = 575) or cirrhosis (n = 2037). Cirrhosis was in the compensated phase (without/with varices) or had previously been in the decompensated stage. Different direct-acting antiviral (DAA) regimens were administered in accordance with scientific guidelines. Results The SVR12 rate was 97.6% in patients with advanced fibrosis. For patients with cirrhosis, the rate was 96.5% in stage 1, 95.1% in stage 2, 100% in stage 3, 95.7% in stage 4, and 93.6% in stage 5. These rates were independent of gender, age, HCV genotype, and treatment schedule. Positive changes in biochemical parameters and CPT classes following therapy were evident in compensated and previously decompensated patients. Conclusion Our findings support the use of DAAs in patients with advanced cirrhosis (stages 3–5) who are at greatest risk and have the most to gain from therapy.
AB - Background Sustained virological response (SVR12) rates at 12 weeks after treatment for HCV-infected patients with decompensated cirrhosis are used when referring to those with moderate functional impairment, while few data are available for those with more severe impairment. The use of the cirrhosis staging system proposed by D'Amico might provide new insights on timing for antiviral therapy. Methods We investigated efficacy (SVR12), safety, and post-treatment variations in clinical and laboratory parameters in 2612 patients with advanced fibrosis (n = 575) or cirrhosis (n = 2037). Cirrhosis was in the compensated phase (without/with varices) or had previously been in the decompensated stage. Different direct-acting antiviral (DAA) regimens were administered in accordance with scientific guidelines. Results The SVR12 rate was 97.6% in patients with advanced fibrosis. For patients with cirrhosis, the rate was 96.5% in stage 1, 95.1% in stage 2, 100% in stage 3, 95.7% in stage 4, and 93.6% in stage 5. These rates were independent of gender, age, HCV genotype, and treatment schedule. Positive changes in biochemical parameters and CPT classes following therapy were evident in compensated and previously decompensated patients. Conclusion Our findings support the use of DAAs in patients with advanced cirrhosis (stages 3–5) who are at greatest risk and have the most to gain from therapy.
KW - Antiviral therapy
KW - Direct-acting antivirals
KW - HCV
KW - Hepatitis C
KW - Liver cirrhosis
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U2 - 10.1016/j.dld.2017.03.025
DO - 10.1016/j.dld.2017.03.025
M3 - Article
AN - SCOPUS:85018424980
VL - 49
SP - 1022
EP - 1028
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 9
ER -