Gut Liver.  2017 Sep;11(5):721-727. 10.5009/gnl17209.

Direct Acting Antiviral Agents in Korean Patients with Chronic Hepatitis C and Hemophilia Who Are Treatment-Naïve or Treatment-Experienced

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. mdjoon@cau.ac.kr
  • 2Department of Pediatrics, Korea Hemophilia Foundation Hospital, Seoul, Korea.

Abstract

BACKGROUND/AIMS
Chronic hepatitis C (CHC) is a major comorbidity in patients with hemophilia.
METHODS
Patients (n=30) were enrolled between September 2015 and April 2016. Twenty-six patients were genotype 1 (1b, n=21; 1a, n=5) and four patients were genotype 2a/2b. Among 21 patients with genotype 1b, Y93H resistance-associated variants (RAVs) were detected in three patients (14.3%). We evaluated sustained virologic response (SVRs) at 12 weeks, as well as relapse and safety.
RESULTS
Five patients with genotype 1a and three patients with genotype 1b (RAV positive) received ledipasvir/sofosbuvir for 12 weeks. SVR12 rate was 100% (8/8). Eleven patients with genotype 1b were treatment-naïve and received daclatasvir plus asunaprevir for 24 weeks. SVR12 rate was 91% (10/11). One patient experienced viral breakthrough without RAV at 12 weeks. Seven treatment-experienced patients with genotype 1b received daclatasvir plus asunaprevir for 24 weeks. SVR12 rate was 85.7% (6/7). One patient experienced viral breakthrough with RAV (L31M, Y93H) at 12 weeks. Four patients with genotype 2a/2b received sofosbuvir plus ribavirin for 12 weeks. SVR12 rate was 100% (4/4). No serious adverse event-related discontinuations were noted.
CONCLUSIONS
New direct acting antiviral treatment achieved high SVRs rates at 12 weeks in CHC patients with hemophilia without serious adverse events.

Keyword

Hepatitis C; chronic; Sofosbuvir; Ledipasvir; Daclatasvir; Asunaprevir

MeSH Terms

Antiviral Agents*
Comorbidity
Genotype
Hemophilia A*
Hepatitis C
Hepatitis C, Chronic*
Hepatitis, Chronic*
Humans
Recurrence
Ribavirin
Sofosbuvir
Antiviral Agents
Ribavirin
Sofosbuvir
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