Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment

ABSTRACT To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The stu...

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Veröffentlicht in:Journal of viral hepatitis 2024-11, Vol.31 (11), p.677-685
Hauptverfasser: Flisiak, Robert, Zarębska‐Michaluk, Dorota, Janczewska, Ewa, Parfieniuk‐Kowerda, Anna, Mazur, Włodzimierz, Sitko, Marek, Janocha‐Litwin, Justyna, Krygier, Rafał, Lorenc, Beata, Piekarska, Anna, Sobala‐Szczygieł, Barbara, Dobrowolska, Krystyna, Socha, Łukasz, Jaroszewicz, Jerzy
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container_end_page 685
container_issue 11
container_start_page 677
container_title Journal of viral hepatitis
container_volume 31
creator Flisiak, Robert
Zarębska‐Michaluk, Dorota
Janczewska, Ewa
Parfieniuk‐Kowerda, Anna
Mazur, Włodzimierz
Sitko, Marek
Janocha‐Litwin, Justyna
Krygier, Rafał
Lorenc, Beata
Piekarska, Anna
Sobala‐Szczygieł, Barbara
Dobrowolska, Krystyna
Socha, Łukasz
Jaroszewicz, Jerzy
description ABSTRACT To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (
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The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (&lt;400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load.</description><identifier>ISSN: 1352-0504</identifier><identifier>ISSN: 1365-2893</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13991</identifier><identifier>PMID: 39109641</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Antiviral agents ; Cirrhosis ; direct‐acting antivirals ; discontinuation ; Genotypes ; HCV ; Hepatitis C ; Patients ; Population studies ; sustained virologic response ; treatment</subject><ispartof>Journal of viral hepatitis, 2024-11, Vol.31 (11), p.677-685</ispartof><rights>2024 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2024 John Wiley &amp; Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2431-a93481f7fe7bedf7c9dc218da4b8c6c3f6fc2d9970d8059230044dc2f5a817d3</cites><orcidid>0000-0002-3815-3745 ; 0000-0002-5406-4603 ; 0000-0003-0352-9893 ; 0000-0003-0938-1084</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13991$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13991$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39109641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flisiak, Robert</creatorcontrib><creatorcontrib>Zarębska‐Michaluk, Dorota</creatorcontrib><creatorcontrib>Janczewska, Ewa</creatorcontrib><creatorcontrib>Parfieniuk‐Kowerda, Anna</creatorcontrib><creatorcontrib>Mazur, Włodzimierz</creatorcontrib><creatorcontrib>Sitko, Marek</creatorcontrib><creatorcontrib>Janocha‐Litwin, Justyna</creatorcontrib><creatorcontrib>Krygier, Rafał</creatorcontrib><creatorcontrib>Lorenc, Beata</creatorcontrib><creatorcontrib>Piekarska, Anna</creatorcontrib><creatorcontrib>Sobala‐Szczygieł, Barbara</creatorcontrib><creatorcontrib>Dobrowolska, Krystyna</creatorcontrib><creatorcontrib>Socha, Łukasz</creatorcontrib><creatorcontrib>Jaroszewicz, Jerzy</creatorcontrib><title>Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>ABSTRACT To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. 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Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (&lt;400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load.</description><subject>Antiviral agents</subject><subject>Cirrhosis</subject><subject>direct‐acting antivirals</subject><subject>discontinuation</subject><subject>Genotypes</subject><subject>HCV</subject><subject>Hepatitis C</subject><subject>Patients</subject><subject>Population studies</subject><subject>sustained virologic response</subject><subject>treatment</subject><issn>1352-0504</issn><issn>1365-2893</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp10E1LAzEQBuAgitaPg39AAl70sDWT7HaTo9RqlYKgxWtIs4mmbDc12VX6701t9SA4l5nDw8vwInQKpA9pruYfb31gQsAO6gEbFBnlgu2u74JmpCD5ATqMcU4IMFrAPjpgAogY5NBDz89dbJVrTIVfXPC1f3Va1fjJxKVvosHXtjUBj1SoV_jGRe2b1jWdap1vsLd4bJbpbl3EQzwNRrUL07THaM-qOpqT7T5C09vRdDjOJo9398PrSaZpziBTguUcbGlNOTOVLbWoNAVeqXzG9UAzO7CaVkKUpOKkEJQRkueJ2EJxKCt2hC42scvg3zsTW7lID5q6Vo3xXZSMcME5ZRwSPf9D574LTXpOMoDESprTpC43SgcfYzBWLoNbqLCSQOS6aJmKlt9FJ3u2TexmC1P9yp9mE7jagE9Xm9X_SfLhZbyJ_AKtxoc8</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Flisiak, Robert</creator><creator>Zarębska‐Michaluk, Dorota</creator><creator>Janczewska, Ewa</creator><creator>Parfieniuk‐Kowerda, Anna</creator><creator>Mazur, Włodzimierz</creator><creator>Sitko, Marek</creator><creator>Janocha‐Litwin, Justyna</creator><creator>Krygier, Rafał</creator><creator>Lorenc, Beata</creator><creator>Piekarska, Anna</creator><creator>Sobala‐Szczygieł, Barbara</creator><creator>Dobrowolska, Krystyna</creator><creator>Socha, Łukasz</creator><creator>Jaroszewicz, Jerzy</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3815-3745</orcidid><orcidid>https://orcid.org/0000-0002-5406-4603</orcidid><orcidid>https://orcid.org/0000-0003-0352-9893</orcidid><orcidid>https://orcid.org/0000-0003-0938-1084</orcidid></search><sort><creationdate>202411</creationdate><title>Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment</title><author>Flisiak, Robert ; 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source Wiley Online Library Journals Frontfile Complete
subjects Antiviral agents
Cirrhosis
direct‐acting antivirals
discontinuation
Genotypes
HCV
Hepatitis C
Patients
Population studies
sustained virologic response
treatment
title Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment
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