Effectiveness of second-generation direct-acting antivirals in patients infected with hepatitis c virus and factors associated with a nonsustained virological response

Abstract

In Brazil, hepatitis C virus (HCV) treatment has gone through several stages until it reached the current schemes. This study aimed to evaluate the clinical, epidemiologic, and effectiveness of treatment with second-generation direct-acting antivirals (DAAs) for HCV-infected patients in southern Brazil. Medical records of a reference center of Uruguaiana-RS/Brazil were evaluated from December 2017 to August 2020. Data collected included demographics, disease severity and comorbidities, genotype, viral load, medications, treatment side effects, and sustained virological response (SVR). A multivariate linear regression model was developed to identify the factors associated with non-sustained virological response. The HCV-infected patients were predominantly male, white, Genotype 1, with initial liver fibrosis (F0/F1), and untreated patients. Laboratory parameters of the liver profile showed significant improvement after completion of treatment with second-generation DAA for 12 weeks. Significant results were found in the Genotype where 7.3 and 6.0 times more chances of Genotype 1a and Genotype 3, respectively, to present detectable SVR compared to Genotype 1b. Variable cardiovascular comorbidity also indicated a higher risk of absence of SVR compared to individuals without this comorbidity. Treatment with second-generation DAAs can contribute to the Brazilian hepatitis C elimination plan proposed by the World Health Organization.

Keywords:
Hepatitis C; Aantivirals; Sustained virologic response; Direct antiviral agents