Generic Direct Acting Antivirals in Treatment of Chronic Hepatitis C Infection in Patients of Thalassemia Major.
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TLDR
Generic DAAs are safe in thalassemia major patients with hepatitis C with efficacy of 100%.Abstract:
Background There is no published data of treating hepatitis C in thalassemia major patients with any sofosbuvir based direct acting antivirals (DAAs). This study was performed to determine the efficacy and safety of these regimes using generic drugs in the thalassemia major population. Methods In this observational study, 902 patients of thalassemia major from five transfusion centres in Mumbai were screened for HCV antibody. Of the 120 positive patients, HCV RNA was detected in 50%. The first 29 patients were enrolled for evaluating the efficacy and safety of generic sofosbuvir based DAAs. Results The 29 patients’ had a mean age of 24 years with genotype 1 in 17, genotype 3 in 11patients, while 1 patient's genotype could not be classified. Six patients had compensated cirrhosis and 8 patients were treatment experienced. SVR 12 was achieved in 100% of patients. There was significant increase in PRC (packed red cell) requirements (P = 0.0003) during treatment. At 12 weeks post-treatment, PRC requirements returned to baseline with a significant fall in serum ferritin (P = 0.03). Headache, fatigue and diarrhoea were the most common side effects. The difference in side effects including anaemia between patients who received ribavirin (19/29) and those who did not receive ribavirin (10/29) was not significant. Presence of diabetes, splenectomy, high ferritin or liver or heart iron overload on MRI T2* did not affect the efficacy of treatment. Conclusion Generic DAAs are safe in thalassemia major patients with hepatitis C with efficacy of 100%. Serum ferritin falls significantly after treatment despite an increase in transfusion requirements during treatment.read more
Citations
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Status of Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection and Remaining Challenges
TL;DR: The status of direct-acting antiviral therapies for hepatitis C virus infection is reviewed, the potential to shorten therapy even further is discussed, and different options for treatment failure and resistance are reviewed.
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2020 Taiwan consensus statement on the management of hepatitis C: Part (II) special populations.
Ming-Lung Yu,Pei-Jer Chen,Chia-Yen Dai,Tsung Hui Hu,Chung Feng Huang,Yi Hsiang Huang,Chao-Hung Hung,Chun-Yen Lin,Chen-Hua Liu,Chun-Jen Liu,Cheng Yuan Peng,Han-Chieh Lin,Jia-Horng Kao,Wan-Long Chuang +13 more
TL;DR: The Taiwan Association for the Study of the Liver (TASL) proposes the treatment recommendations for the special population in order to serve as guidance to optimizing the outcome in the direct-acting antiviral (DAA) era.
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Treatment of Chronic Hepatitis C Infection with Direct Acting Antivirals in Adolescents with Thalassemia Major.
Aabha Nagral,Ajay Jhaveri,Smita Sawant,Nirzar Samir Parikh,Nishtha Nagral,Rashid H. Merchant,Mihir Gandhi +6 more
TL;DR: Generic DAAs are effective and safe in TM adolescents with HCV and there was a significant reduction in alanine aminotransferase levels, HCV RNA load and ferritin levels at 3 mo post completion of treatment.
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Direct-acting antiviral Therapy Is Safe and Effective in Pediatric Chronic Hepatitis C: The Public Health Perspective.
Radha K. Dhiman,Gagandeep Singh Grover,Madhumita Premkumar,Sunil Taneja,Ajay Duseja,Sahaj Rathi,Sandeep Satsangi +6 more
TL;DR: The study demonstrates that the decentralized algorithm-based public-health program can ensure high efficacy (SVR12, 98.2%) and low-cost DAA-based treatment of pediatric patients with CHC and shows the efficacy of decentralized public health services and safety of direct-acting antiviral agents (DAAs) in Punjab, India.
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Effectiveness of generic direct-acting agents for the treatment of hepatitis C: systematic review and meta-analysis.
Hugo Perazzo,Rodolfo Castro,Paula M. Luz,Mariana Banholi,Rafaela V Goldenzon,Sandra W. Cardoso,Beatriz Grinsztejn,Valdilea G. Veloso +7 more
TL;DR: Generic direct-acting agents are highly effective for treating hepatitis C and should be considered in resource-constrained settings for decreasing the burden of liver disease in HCV-infected patients.
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TL;DR: Treatment with generic DAAs available in India will improve patient outcomes, provide a good value for money within 2 years, and be ultimately cost-saving.
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