Characterization of patients with chronic hepatitis C treated in a tertiary referral center in Medellín
DOI:
https://doi.org/10.22516/25007440.328Keywords:
Hepatitis C, Colombia, antivirals, interferon, direct action antiviralsAbstract
Introduction: Throughout the world hepatitis C (HepC) is a public health problem. Estimates for its prevalence in Colombia range from 0.5% to 1% but 2.1 % for patients over 50 years of age. The Hepatology Unit at the Hospital Pablo Tobón Uribe (HPTU) has been a benchmark for management of HepC in Medellín and Colombia for years.
Objective: To describe sociodemographic and clinical characteristics together with health outcomes of patients with chronic HepC who were treated at the HPTU between 2013 and 2018.
Materials and methods: This is an observational, descriptive and retrospective study of patients with chronic HepC, treated between January 1, 2013 and March 31, 2018.
Results: One hundred and eight patients were analyzed. The average age was 55.8 years (SD 13.7), 51.9% were men, and 78.7% belonged to the contributory health care scheme. Most frequently, the disease was transmitted by blood, and genotype 1 predominated in the group of patients analyzed. The effectiveness of interferon schemes was 46.9% while that of Direct Action Antivirals (ADF) was 94.6%. Adverse drug reactions were found in 68.2% of patients treated with interferon/ribavirin schemes but in only 25.9% of the patients treated with ADF.
Conclusions: In this group of patients treated at HPTU, ADAs were safer and more effective than interferon/ribavirin schemes.
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References
Hajarizadeh B, Grebely J, Dore GJ. Epidemiology and natural history of HCV infection. Nat Rev Gastroenterol Hepatol. 2013 Sep;10(9):553-62. https://doi.org/10.1038/nrgastro.2013.107.
Kohli A, Shaffer A, Sherman A, Kottilil S. Treatment of hepatitis C: a systematic review. JAMA. 2014 Aug 13;312(6):631-40. https://doi.org/10.1001/jama.2014.7085.
Center for Disease Analysis. Hepatitis C prevalence [Internet]. 2012 [acceso 19 de febrero de 2017]. Disponible en: http://www.centerforda.com/HepC/HepMap.html.
American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C [Internet]. 2016 [acceso 23 de marzo de 2017]. Disponible en: http://www.hcvguidelines.org/full-report-view.
Ministerio de Salud y Protección Social, Instituto de Evaluación Tecnológica en Salud. Guía de Práctica Clínica para la tamización, diagnóstico y tratamiento de personas con infección por el virus de la hepatitis C. Bogotá, Colombia: Ministerio de Salud y Protección Social; 2016.
Strader DB, Seeff LB. A brief history of the treatment of viral hepatitis C. Clin Liver Dis (Hoboken). 2012 Mar 6;1(1):6-11. https://doi.org/10.1002/cld.1.
Calleja JL, Crespo J, Rincón D, Ruiz-Antorán B, Fernandez I, Perelló C, et al. Effectiveness, safety and clinical outcomes of direct-acting antiviral therapy in HCV genotype 1 infection: Results from a Spanish real-world cohort. J Hepatol. 2017 Jun;66(6):1138-1148. https://doi.org/10.1016/j.jhep.2017.01.028.
Yang S, Britt RB, Hashem MG, Brown JN. Outcomes of Pharmacy-Led Hepatitis C Direct-Acting Antiviral Utilization Management at a Veterans Affairs Medical Center. J Manag Care Spec Pharm. 2017 Mar;23(3):364-369. https://doi.org/10.18553/jmcp.2017.23.3.364.
Sistema de Trámites en Línea - Consultas Públicas [Internet]. [acceso 30 de julio de 2018]. Disponible en: http://consultaregistro.invima.gov.co:8082/Consultas/consultas/consreg_encabcum.jsp.
Santos Ó, Gómez A, Vizcaíno V, Casas MC, Ramírez MDP, Olaya P. [Hepatitis C virus genotypes circulating in Colombia]. Biomedica. 2017 Jan 24;37(1):22-27. https://doi.org/10.7705/biomedica.v37i1.3173.
Yepes I de J, Carmona ZA, Múnera MN. Calidad de vida en pacientes con hepatitis C crónica en Colombia. Rev Colomb Gastroenterol. 2017;32(2):112. https://doi.org/10.22516/25007440.139.
Yepes I de J, Lince B, Caez C, Vuono G de. Factores de riesgo para la infección por el virus de la hepatitis C en la Costa Caribe colombiana: un estudio de casos y controles. Biomédica. 2016;36(4):564-71. https://doi.org/10.7705/biomédica.v36i4.3105.
Claudino Botero R, Tagle M. Los nuevos tratamiento de hepatitis C: Perspectivas latinoamericanas. Clin Liver Dis (Hoboken). 2015 Mar 4;5(1):11-13. https://doi.org/10.1002/cld.466.
Beltrán M. Riesgo de infección transfusional de hepatitis C en Colombia. Iatreia. 2004;17(3-S):305.
Saludes V, Ausina V, Martró E. Posibilidades actuales para predecir la respuesta a la terapia en pacientes con hepatitis C crónica por el genotipo 1 del virus de la hepatitis C. Enfermedades Infecc Microbiol Clínica. 2011;29:51-8. https://doi.org/10.1016/S0213-005X(11)70044-1.
Buti M, Riveiro-Barciela M, Esteban R. Management of direct-acting antiviral agent failures. J Hepatol. 2015 Dec;63(6):1511-22. https://doi.org/10.1016/j.jhep.2015.08.010.
Llerena S, Cabezas J, Iruzubieta P, Crespo J. Resistencias al virus de la hepatitis C. Implicaciones y posibilidades terapéuticas. Gastroenterol Hepatol. 2017;484-94. https://doi.org/10.1016/j.gastrohep.2017.04.007.
Dietz J, Susser S, Berkowski C, Perner D, Zeuzem S, Sarrazin C. Consideration of Viral Resistance for Optimization of Direct Antiviral Therapy of Hepatitis C Virus Genotype 1-Infected Patients. PLoS One. 2015 Aug 28;10(8):e0134395. https://doi.org/10.1371/journal.pone.0134395.
Sarrazin C, Dvory-Sobol H, Svarovskaia ES, Doehle B, Martin R, Zeuzem S, et al. The prevalence and the effect of HCV NS5A resistance associated variants in subjects with compensated cirrhosis treated with ledipasvir/sofosbuvir +/- RBV. J Hepatol. 2015;62:S620. https://doi.org/10.1016/S0168-8278(15)30976-4.
Ministerio de Salud y Protección Social, Instituto de Evaluación Tecnológica en Salud. Vía clínica para el tratamiento de hepatitis C. Bogotá, Colombia: Ministerio de Salud y Protección Social; 2017. p. 41.
Santos OM, Orrego M. Tratamiento: Efectos adversos del tratamiento de hepatitis C. Rev Colomb Gastroenterol. 2012;27:37-40.
Mulet Pérez A, Pullés Labadié M, Gámez Escalona M, Mulet Gámez A, Díaz Santos O, Infante Velázquez M. Efectos adversos del tratamiento con interferón alfa-2b humano recombinante y rivabirina en pacientes con hepatitis crónica C. Rev Cuba Med Mil. 2011;40(1):76-84.
Sulkowski MS, Cooper C, Hunyady B, Jia J, Ogurtsov P, Peck-Radosavljevic M, Shiffman ML, Yurdaydin C, Dalgard O. Management of adverse effects of Peg-IFN and ribavirin therapy for hepatitis C. Nat Rev Gastroenterol Hepatol. 2011 Apr;8(4):212-23. https://doi.org/10.1038/nrgastro.2011.21.
Huang YM, Wang H, Wang C, Chen M, Zhao MH. Promotion of hypercoagulability in antineutrophil cytoplasmic antibody-associated vasculitis by C5a-induced tissue factor-expressing microparticles and neutrophil extracellular traps. Arthritis Rheumatol. 2015 Oct;67(10):2780-90. https://doi.org/10.1002/art.39239.
Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Marcellin P, Ramadori G, Bodenheimer H Jr, Bernstein D, Rizzetto M, Zeuzem S, Pockros PJ, Lin A, Ackrill AM; PEGASYS International Study Group. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004 Mar 2;140(5):346-55. https://doi.org/10.7326/0003-4819-140-5-200403020-00010.
Nachnani JS, Rao GA, Bulchandani D, Pandya PK, Alba LM. Predictors of hematological abnormalities in patients with chronic hepatitis C treated with interferon and ribavirin. Ann Hematol. 2010 Feb;89(2):121-5. https://doi.org/10.1007/s00277-009-0774-y.
UpToDate Inc. Ribavirin (systemic): Drug information [Internet]. [acceso 10 de agosto de 2018]. Disponible en: http://www.uptodate.com
Barrajón L, Soler E, Lorente L, Pérez J. Efectividad y seguridad de los antivirales de acción directa frente al virus de la hepatitis C. Rev OFIL. 2016;26(4):243-50.
Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017 Oct 10;17(1):230. https://doi.org/10.1186/s12877-017-0621-2.
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