Abstract:
There are approximately 185 million HCV infected people all over the world. A
serious problem of HCV infection is the high chronicity rate of about 80%
HCV-infected patients may develop liver cirrhosis or hepatocellular carcinoma.
The HCV standard therapy with interferon and ribavirin was used since1990s, the
success rate of this treatment was only about 50%, and it was HCV genotype
dependent. This changed significantly since the direct-acting antivirals (DAAs)
became available from 2014 onwards. The success rate is about 95% and can be
achieved in a very short time.
In this study, 437 patients with HCV infection who were treated at the University
Hospital Tübingen in the period from Jan. 2014 to April 2017 were analyzed. In the
cohort, six patients were coinfected with HIV and two patients were coinfected with
HBV. The rate of coinfection was relatively low because of the specific patient
population of the Tübingen University Clinic. In larger cities, the prevalence of HBV
and especially HIV infection is higher. In this cohort, 15 patients relapsed after the
treatment and the HCV RNA was detectable in the blood. These 15 patients are
analyzed during treatment and after treatment with respect to multiple factors such as
viral load.
Since different treatment regimens and treatment durations (8 weeks, 12 weeks,
24 weeks) were used, these were related to laboratory and clinical parameters such as
HCV genotypes, age, and gender of the patients, coinfections, etc.
The most striking correlation was seen between relapse and liver cirrhosis. This
also explained the unexpected finding that the patients with the longer treatment of 24
weeks treatment duration had a higher relapse rate than the patients with 8 weeks or
12 weeks duration. However, the 24 weeks treatment duration is mainly consisted by
liver cirrhosis patients.
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The analysis in this study shows impressively quick treatment success rate of
95.95% of the new direct-acting antivirals (DAAs) in HCV infected patients. The
liver cirrhosis patients and the low PLT patients had the lower success rate.