Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort)
Background Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical...
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| Veröffentlicht in: | Hepatology international 2019-01, Vol.13 (1), p.66-74 |
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| creator | Gentile, Ivan Scotto, Riccardo Coppola, Carmine Staiano, Laura Amoruso, Daniela Caterina De Simone, Teresa Portunato, Federica De Pascalis, Stefania Martini, Salvatore Macera, Margherita Viceconte, Giulio Tosone, Grazia Buonomo, Antonio Riccardo Borgia, Guglielmo Coppola, Nicola |
| description | Background
Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis.
Methods
We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs.
Results
Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (
p
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| doi_str_mv | 10.1007/s12072-018-9914-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2155929118</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2155929118</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-7475bc6034b371343511090475880b868db478e86cbb1cdac070c83a7366ad7d3</originalsourceid><addsrcrecordid>eNp1kU1uFDEQhVsIRELgAGyQJTZhYbDb7Z9mNxoBGWkUNoFty-2uyTi47cF2T5Qdh-BW3IKT4KGHICGxKrv81asnv6p6TslrSoh8k2hNZI0JVbhtaYPFg-qUtkxgwhv68P7M2En1JKUbQjgXVDyuThjhNeO8Pq1-XEXQeQSf0a3NWzTYCCZjbbL110j7bPc2apeQHXcx7CGhvAVknPXWaIfClE0YAVmPdjrbIpNmnYvlZxzB6QwDGqAwO_Dp983YGLch2fQWRUiTKxObGMayC62ydrbUYslhZzdlUdiGmNH52u4hokvItyF-QQtzsJXvfn77vl5dLo7Uq6fVo02xCs-O9az69P7d1fICrz9-WC0Xa2yYrDOWjeS9EYQ1PZOUNYxTSlpSukqRXgk19I1UoITpe2oGbYgkRjEtmRB6kAM7q85n3fIjXydIuRttMuCc9hCm1NWU87ZuKVUFffkPehOm6Iu7A0VazhRjhaIzZWJIKcKm20U76njXUdIdku7mpLuSdHdIuhNl5sVReepHGO4n_kRbgHoGUnny1xD_rv6_6i-gPbec</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2150953833</pqid></control><display><type>article</type><title>Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort)</title><source>SpringerLink Journals</source><creator>Gentile, Ivan ; Scotto, Riccardo ; Coppola, Carmine ; Staiano, Laura ; Amoruso, Daniela Caterina ; De Simone, Teresa ; Portunato, Federica ; De Pascalis, Stefania ; Martini, Salvatore ; Macera, Margherita ; Viceconte, Giulio ; Tosone, Grazia ; Buonomo, Antonio Riccardo ; Borgia, Guglielmo ; Coppola, Nicola</creator><creatorcontrib>Gentile, Ivan ; Scotto, Riccardo ; Coppola, Carmine ; Staiano, Laura ; Amoruso, Daniela Caterina ; De Simone, Teresa ; Portunato, Federica ; De Pascalis, Stefania ; Martini, Salvatore ; Macera, Margherita ; Viceconte, Giulio ; Tosone, Grazia ; Buonomo, Antonio Riccardo ; Borgia, Guglielmo ; Coppola, Nicola</creatorcontrib><description>Background
Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis.
Methods
We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs.
Results
Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (
p
< 0.001). Liver parameters significantly improved from baseline to 12 weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1 month of treatment were significantly associated with a decompensated cirrhosis at the last observation.
Conclusions
Treatment with DAA in patients with Child–Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-018-9914-6</identifier><identifier>PMID: 30523552</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Antiviral agents ; Antiviral drugs ; Cirrhosis ; Clinical outcomes ; Colorectal Surgery ; Genotypes ; Hepatology ; Liver ; Liver cirrhosis ; Medicine ; Medicine & Public Health ; Original Article ; Patients ; Quality of life ; Surgery</subject><ispartof>Hepatology international, 2019-01, Vol.13 (1), p.66-74</ispartof><rights>Asian Pacific Association for the Study of the Liver 2018</rights><rights>Hepatology International is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-7475bc6034b371343511090475880b868db478e86cbb1cdac070c83a7366ad7d3</citedby><cites>FETCH-LOGICAL-c372t-7475bc6034b371343511090475880b868db478e86cbb1cdac070c83a7366ad7d3</cites><orcidid>0000-0002-0178-2986</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12072-018-9914-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12072-018-9914-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30523552$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gentile, Ivan</creatorcontrib><creatorcontrib>Scotto, Riccardo</creatorcontrib><creatorcontrib>Coppola, Carmine</creatorcontrib><creatorcontrib>Staiano, Laura</creatorcontrib><creatorcontrib>Amoruso, Daniela Caterina</creatorcontrib><creatorcontrib>De Simone, Teresa</creatorcontrib><creatorcontrib>Portunato, Federica</creatorcontrib><creatorcontrib>De Pascalis, Stefania</creatorcontrib><creatorcontrib>Martini, Salvatore</creatorcontrib><creatorcontrib>Macera, Margherita</creatorcontrib><creatorcontrib>Viceconte, Giulio</creatorcontrib><creatorcontrib>Tosone, Grazia</creatorcontrib><creatorcontrib>Buonomo, Antonio Riccardo</creatorcontrib><creatorcontrib>Borgia, Guglielmo</creatorcontrib><creatorcontrib>Coppola, Nicola</creatorcontrib><title>Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort)</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Background
Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis.
Methods
We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs.
Results
Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (
p
< 0.001). Liver parameters significantly improved from baseline to 12 weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1 month of treatment were significantly associated with a decompensated cirrhosis at the last observation.
Conclusions
Treatment with DAA in patients with Child–Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.</description><subject>Antiviral agents</subject><subject>Antiviral drugs</subject><subject>Cirrhosis</subject><subject>Clinical outcomes</subject><subject>Colorectal Surgery</subject><subject>Genotypes</subject><subject>Hepatology</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Surgery</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1uFDEQhVsIRELgAGyQJTZhYbDb7Z9mNxoBGWkUNoFty-2uyTi47cF2T5Qdh-BW3IKT4KGHICGxKrv81asnv6p6TslrSoh8k2hNZI0JVbhtaYPFg-qUtkxgwhv68P7M2En1JKUbQjgXVDyuThjhNeO8Pq1-XEXQeQSf0a3NWzTYCCZjbbL110j7bPc2apeQHXcx7CGhvAVknPXWaIfClE0YAVmPdjrbIpNmnYvlZxzB6QwDGqAwO_Dp983YGLch2fQWRUiTKxObGMayC62ydrbUYslhZzdlUdiGmNH52u4hokvItyF-QQtzsJXvfn77vl5dLo7Uq6fVo02xCs-O9az69P7d1fICrz9-WC0Xa2yYrDOWjeS9EYQ1PZOUNYxTSlpSukqRXgk19I1UoITpe2oGbYgkRjEtmRB6kAM7q85n3fIjXydIuRttMuCc9hCm1NWU87ZuKVUFffkPehOm6Iu7A0VazhRjhaIzZWJIKcKm20U76njXUdIdku7mpLuSdHdIuhNl5sVReepHGO4n_kRbgHoGUnny1xD_rv6_6i-gPbec</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Gentile, Ivan</creator><creator>Scotto, Riccardo</creator><creator>Coppola, Carmine</creator><creator>Staiano, Laura</creator><creator>Amoruso, Daniela Caterina</creator><creator>De Simone, Teresa</creator><creator>Portunato, Federica</creator><creator>De Pascalis, Stefania</creator><creator>Martini, Salvatore</creator><creator>Macera, Margherita</creator><creator>Viceconte, Giulio</creator><creator>Tosone, Grazia</creator><creator>Buonomo, Antonio Riccardo</creator><creator>Borgia, Guglielmo</creator><creator>Coppola, Nicola</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0178-2986</orcidid></search><sort><creationdate>20190101</creationdate><title>Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort)</title><author>Gentile, Ivan ; Scotto, Riccardo ; Coppola, Carmine ; Staiano, Laura ; Amoruso, Daniela Caterina ; De Simone, Teresa ; Portunato, Federica ; De Pascalis, Stefania ; Martini, Salvatore ; Macera, Margherita ; Viceconte, Giulio ; Tosone, Grazia ; Buonomo, Antonio Riccardo ; Borgia, Guglielmo ; Coppola, Nicola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7475bc6034b371343511090475880b868db478e86cbb1cdac070c83a7366ad7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Antiviral agents</topic><topic>Antiviral drugs</topic><topic>Cirrhosis</topic><topic>Clinical outcomes</topic><topic>Colorectal Surgery</topic><topic>Genotypes</topic><topic>Hepatology</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Patients</topic><topic>Quality of life</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gentile, Ivan</creatorcontrib><creatorcontrib>Scotto, Riccardo</creatorcontrib><creatorcontrib>Coppola, Carmine</creatorcontrib><creatorcontrib>Staiano, Laura</creatorcontrib><creatorcontrib>Amoruso, Daniela Caterina</creatorcontrib><creatorcontrib>De Simone, Teresa</creatorcontrib><creatorcontrib>Portunato, Federica</creatorcontrib><creatorcontrib>De Pascalis, Stefania</creatorcontrib><creatorcontrib>Martini, Salvatore</creatorcontrib><creatorcontrib>Macera, Margherita</creatorcontrib><creatorcontrib>Viceconte, Giulio</creatorcontrib><creatorcontrib>Tosone, Grazia</creatorcontrib><creatorcontrib>Buonomo, Antonio Riccardo</creatorcontrib><creatorcontrib>Borgia, Guglielmo</creatorcontrib><creatorcontrib>Coppola, Nicola</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gentile, Ivan</au><au>Scotto, Riccardo</au><au>Coppola, Carmine</au><au>Staiano, Laura</au><au>Amoruso, Daniela Caterina</au><au>De Simone, Teresa</au><au>Portunato, Federica</au><au>De Pascalis, Stefania</au><au>Martini, Salvatore</au><au>Macera, Margherita</au><au>Viceconte, Giulio</au><au>Tosone, Grazia</au><au>Buonomo, Antonio Riccardo</au><au>Borgia, Guglielmo</au><au>Coppola, Nicola</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort)</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>13</volume><issue>1</issue><spage>66</spage><epage>74</epage><pages>66-74</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>Background
Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis.
Methods
We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs.
Results
Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (
p
< 0.001). Liver parameters significantly improved from baseline to 12 weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1 month of treatment were significantly associated with a decompensated cirrhosis at the last observation.
Conclusions
Treatment with DAA in patients with Child–Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>30523552</pmid><doi>10.1007/s12072-018-9914-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0178-2986</orcidid></addata></record> |
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| subjects | Antiviral agents Antiviral drugs Cirrhosis Clinical outcomes Colorectal Surgery Genotypes Hepatology Liver Liver cirrhosis Medicine Medicine & Public Health Original Article Patients Quality of life Surgery |
| title | Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity—LINA cohort) |
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