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A real-life study of the positive response to DAA-based therapies for hepatitis C in Brazil.
Vivaldini, Simone Monzani; Ribeiro, Rachel Abraão; Mosimann Júnior, Gláucio; Tonini, Karen Cristine; Pereira, Gerson Fernando Mendes; Araújo, Wildo Navegantes de.
Afiliação
  • Vivaldini SM; Ministry of Health, Secretariat for Health Surveillance, Department of Chronic Conditions Diseases and Other Sexually Transmitted Infections, Brasília, DF, Brazil; University of Brasília (UnB), Faculty of Medicine, Center for Tropical Medicine, Brasília, DF, Brazil. Electronic address: simonevivaldi
  • Ribeiro RA; Ministry of Health, Secretariat for Health Surveillance, Department of Chronic Conditions Diseases and Other Sexually Transmitted Infections, Brasília, DF, Brazil.
  • Mosimann Júnior G; Ministry of Health, Secretariat for Health Surveillance, Department of Chronic Conditions Diseases and Other Sexually Transmitted Infections, Brasília, DF, Brazil.
  • Tonini KC; Ministry of Health, Secretariat for Health Surveillance, Department of Chronic Conditions Diseases and Other Sexually Transmitted Infections, Brasília, DF, Brazil.
  • Pereira GFM; Ministry of Health, Secretariat for Health Surveillance, Department of Chronic Conditions Diseases and Other Sexually Transmitted Infections, Brasília, DF, Brazil.
  • Araújo WN; University of Brasília (UnB), Faculty of Medicine, Center for Tropical Medicine, Brasília, DF, Brazil; National Institute for Science and Technology for Health Technology Assessment, Porto Alegre, RS, Brazil; University of Brasília (UnB), Faculty of Ceilândia, Brasília, DF, Brazil.
Braz J Infect Dis ; 25(2): 101573, 2021.
Article em En | MEDLINE | ID: mdl-33836175
A retrospective cohort of 11,308 chronic hepatitis C infected patients treated with regimens that included Sofosbuvir (SOF), Daclatasvir (DCV), Simeprevir (SMV), or an association of Ombitasvir, Veruprevir/Ritonavir and Dasabuvir (3D) with or without Ribavirin (RBV) were assessed for sustained virologic response (SVR) or viral cure after a 12-week treatment. Logistic regression analyses were used to identify factors independently associated with positive response to direct-acting antivirals (DAA)-based therapies. Overall 57.1% were male; 48.3% self-identified as white; 78.3% were over 50 years old; 44.1% were from the Southeast region; 47.7% had genotype 1b; and 84.5% were treated for 12 weeks. The SVR rates with DAAs ranged from 87% to 100%. Genotypes 1 and 4 had higher SVR rates (96.3-100%), and genotypes 2 and 3 had SVR of 90.6-92.2%, respectively. Treatment durations of 12 and 24 weeks were associated with an average SVR of 95.0% and 95.9%, respectively. Females were half as likely (OR 0.5; 95% CI 0.4-0.6) to have a negative response to therapy compared to males, and those with genotypes 2 and 3 were one and half fold more likely (OR 1.5-2.2; 95 CI% 0.7-2.9; 1.2-3.6 and OR 2.7-2.8; 95% CI 2.0-3.8, respectively) to not have SVR compared to genotype 1. Patients in the age-range of 50-69 years old were 1.2-fold (OR 1.2; 95% CI 0.7-1.9) more likely to not have SVR compared to other age groups, although not statistically significant. This study is the first of this magnitude to be held in a Latin-American country with high SVR results, supported by a free-of-charge universal and public health system. The high performance found in this study gives support to the Brazilian public health policy decision of adopting DAA-based therapies as a strategy to eliminate HCV by 2030.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hepatite C / Hepatite C Crônica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Braz J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de publicação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hepatite C / Hepatite C Crônica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Braz J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de publicação: Brasil