ABSTRACT

Background

Second generation direct acting antivirals (DAAs) drastically changed the landscape of chronic HCV (CHCV). Aim of this paper was to assess the effectiveness of DAAs, also looking at the demographic characteristics of subjects enrolled.

Research design and methods

Ambispective multi-center real-life study conducted among patients with CHCV treated with DAAs in Campania Region (Southern Italy). Patient were enrolled in two cohorts according to time of enrolment.

Results

1,479 patients were enrolled. Patients aged ≥60 years were 74.7% in the historic cohort (953 patients) and 70.2% in the prospective cohort (526 patients. Patients aged ≥ 60 years showed a higher prevalence of genotype 1b (p<0.001) and 2 (p<0.001), while patients aged < 60 years showed a higher prevalence of genotype 1a (p<0.001), 3 (p<0.001) and 4 (p<0.05). SVR12 was 98.5% in both cohorts. SVR12 was similar among patients of the prospective cohort aged < and ≥ 60 years (99.4% vs 98.1%). SVR12 among patients with and without cirrhosis was 96.0% and 98.9%, respectively.

Conclusions

DAAs provide high efficacy also in harder to treat patients. The effectiveness of DAAs is leading to a shift in patients characteristics with a greater prevalence of younger subjects and persons with mild liver disease.

中文翻译：

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意大利丙肝病毒感染流行地区接受直接抗丙肝病毒药物治疗和持续高 SVR12 的患者的流行病学变化：现实生活中的“肝脏网络活动”（LINA）队列更新结果

摘要

背景

第二代直接作用抗病毒药物 (DAA) 彻底改变了慢性丙型肝炎病毒 (CHCV) 的现状。本文的目的是评估 DAA 的有效性，同时考察所登记受试者的人口统计学特征。

研究设计与方法

在坎帕尼亚地区（意大利南部）接受 DAA 治疗的 CHCV 患者中进行的双向多中心现实生活研究。根据入组时间，患者被纳入两个队列。

结果

1,479 名患者入组。≥60 岁的患者在历史队列（953 名患者）中占 74.7%，在前瞻性队列（526 名患者）中占 70.2%。年龄≥60 岁的患者显示基因型 1b（p<0.001）和 2（p<0.001）的患病率较高)，而年龄 < 60 岁的患者显示基因型 1a (p<0.001)、3 (p<0.001) 和 4 (p<0.05) 的患病率较高。两个队列的 SVR12 为 98.5%。年龄 < 和 ≥ 60 岁的前瞻性队列（99.4% vs 98.1%）。肝硬化和非肝硬化患者的 SVR12 分别为 96.0% 和 98.9%。

结论

DAA 在难以治疗的患者中也提供了高功效。DAA 的有效性正在导致患者特征发生变化，年轻受试者和轻度肝病患者的患病率更高。