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INTRODUCTION: Genotypes 2 and 3 chronic hepatitis C (CHC) patients are less frequently seen than genotype 1 in Turkey. While these genotypes have had favorable treatment outcomes with interferon-based regimens, response rates are lower with direct acting antivirals (DAAs). We aimed to evaluate efficiency and safety of DAAs in CHC patients infected with genotype 2 and 3.
METHODS: Between April 2017 and September 2018, 37 centers recorded 2230 patients. All patients >18 years with CHC under DAAs were enrolled in this observational study. Those infected with genotype 2 and 3 were analyzed for end of treatment response (EoTR) and response at week 12 (SVR12).
RESULTS: Among 2230 patients recorded into the database; 267 (12%) were infected with genotype 2 or 3, 73 (27%) were female and mean age was 41.7±17 years (range 18-84 years). The genotypes were 3 in 189 (71%) and 2 in 78 (29%). 25 (9.4%) had cirrhosis; 24 had compensated (Child-Pugh A) and 1 had decompensated (Child-Pugh B-C) cirrhosis. Liver biopsy was available in 151 (57%, G3: 107, G2: 44) patients; mean histologic activity index (HAI) was 7.4 and fibrosis score was 2.4. HAI was mild (1-6) in 37%, moderate (7-12) in 59%, and severe (13-18) in 4%. Fibrosis was mild in 49%, moderate in 47%, and advanced in 4%. While 200 (79%) patients were treatment-naive, 57 (21%) were previously treated with pegylated interferon+ribavirin: 74% relapse and 26% non-responder. Baseline viral load was 5.3x106 copies/mL. Ledipasvir + Sofosbuvir, Ledipasvir + Sofosbuvir + Ribavirin and Sofosbuvir + Ribavirin were given to 8, 15, and 154 patients, respectively. The drugs were tolerated well. Severe adverse events were not reported. SVR was evaluated in 134 patients, shown in Table 1. Response rate at week 4 was 119/147 (81%), EoTR 143/144 (%99.3%) and SVR12 128/134 (95.5%).
CONCLUSION: This study represents the largest study of genotypes 2 and 3 CHC in Turkey. Genotype 3 is much commoner than genotype 2 (71% vs 29%). Rate of male gender was higher (73%) and mean age was 42 years. Liver histology showed moderate to higher activity in more than half of the patients and fibrosis was moderate to severe in half. Sofosbuvir and ribavirin containing regimens provided a SVR of more than 90%. The response rate in genotype 2 (94%) was lower than that in genotype 3 (96.5%). DAAs containing sofosbuvir and ribavirin have found efficient and safe among genotype 2 and 3 CHC patients in Turkey.
*This study was supported by Gilead Sciences İlaç Ltd. Şti. (İstanbul, Turkey). Company was not involved to the content of the study/publication; no involvement to the decision to submit for publication.
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Article Info
Published In
Journal
Turkish Journal of Gastroenterology
Volume / Issue
Volume 30 · Issue Supplement 1
Pages
59-60
History
Published Online
July 25, 2019
Copyright
Copyright (c) 2019 Behice Kurtaran, Figen Sarıgül, Mehmet Çabalak, Sibel Kaya, Nagehan Didem Sarı, Hasan Karsen, Esra Zerdali, Rahmet Güner, Kamuran Türker, Nevin Ince, Fehmi Tabak, Hepcturkey Study Group
Affiliations
Behice Kurtaran
Cukurova University Faculty of Medicine Department of Infectious Diseases Adana Turkey
Figen Sarıgül
Antalya Training and Research Hospital Department of Infectious Diseases Antalya Turkey
Mehmet Çabalak
Mustafa Kemal University Faculty of Medicine Infectious Diseases Department Hatay Turkey
Sibel Kaya
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Nagehan Didem Sarı
Istanbul Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Hasan Karsen
Harran University Faculty of Medicine Infectious Diseases Department Şanlıurfa Turkey
Esra Zerdali
Haseki Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Rahmet Güner
Yıldırım Beyazıt University Faculty of Medicine Infectious Diseases Department Ankara Turkey
Kamuran Türker
Bağcılar Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Nevin Ince
Düzce University Düzce Turkey
Fehmi Tabak
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Hepcturkey Study Group
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Cite this Article
Kurtaran, B., Sarıgül, F., Çabalak, M., Kaya, S., Sarı, N. D., Karsen, H., … Group, H. S. (2019). Efficiency and safety of direct acting antivirals in chronic hepatitis C patients ınfected with genotype 2 and 3 in Turkey. Turkish Journal of Gastroenterology, 30(Supplement 1), 59–60. https://doi.org/10.5152/tjg.2019.38
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