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Direct acting antivirals are effective and safe in intravenous drug users with chronic HCV Preview of your abstract file infection: First report from Turkey

Volume 30 · Issue Supplement 1 Publish Date: July 25, 2019
Fehmi Tabak Behice Kurtaran Esra Zerdali Selma Tosun Şaban Esen Nefie Çuvalcı Öztoprak Kamuran Türker Nagehan Didem Sarı Yusuf Önlen Tansu Yamazhan Kenan Hızel Hepcturkey Study Group
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Published In

Turkish Journal of Gastroenterology

Volume 30 · Issue Supplement 1

Pages: 61-62

History

Published Online: July 25, 2019

Copyright © 2019 Fehmi Tabak, Behice Kurtaran, Esra Zerdali, Selma Tosun, Şaban Esen, Nefie Çuvalcı Öztoprak, Kamuran Türker, Nagehan Didem Sarı, Yusuf Önlen, Tansu Yamazhan, Kenan Hızel, Hepcturkey Study Group

Fehmi Tabak
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Behice Kurtaran
Cukurova University Faculty of Medicine Department of Infectious Diseases Adana Turkey
Esra Zerdali
Haseki Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Selma Tosun
Bozyaka Training and Research Hospital Infectious Diseases Department İzmir Turkey
Şaban Esen
19 Mayıs University Faculty of Medicine Infectious Diseases Department Samsun Turkey
Nefie Çuvalcı Öztoprak
Antalya Training and Research Hospital Infectious Diseases Department Antalya Turkey
Kamuran Türker
Bağcılar Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Nagehan Didem Sarı
Istanbul Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Yusuf Önlen
Mustafa Kemal University Faculty of Medicine Infectious Diseases Department Hatay Turkey
Tansu Yamazhan
Ege University Faculty of Medicine Infectious Diseases Department İzmir Turkey
Kenan Hızel
Gazi University Faculty of Medicine Infectious Diseases Department Ankara Turkey
Hepcturkey Study Group
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Tabak, F., Kurtaran, B., Zerdali, E., Tosun, S., Esen, Şaban, Çuvalcı Öztoprak, N., … Group, H. S. (2019). Direct acting antivirals are effective and safe in intravenous drug users with chronic HCV Preview of your abstract file infection: First report from Turkey. Turkish Journal of Gastroenterology, 30(Supplement 1), 61–62. https://doi.org/10.5152/tjg.2019.39
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Abstract

INTRODUCTION: More than half of the intravenous drug users (IDUs) are infected with hepatitis C infection (HCV) in Turkey and there has been a trend to increase in the numbers of IDUs. Direct-acting antivirals (DAAs) have been recently reimbursed for HCV treatment. We analyzed for the efficiency and safety of DAAs for Turkish IDUs. METHODS: From 37 centers, 18 years old and above patients planned DAA treatment between April 2017 and September 2018 were enrolled into the study.  RESULTS: Among the 2230 patients, the way of transmission was unknown in 1754 and among the remaining 476, 169 (7.8% of all) were IDUs (159, 94.1% male, mean age 31±10 years). Genotypes were G3: 80 (47.6%), G1: 54 (32.1%), G2: 17 (10.1%), G4: 16 (9.5%), and G5: 1 (0.6%). Among G1, 54 were subgenotyped: 30 (55.6%) were G1a and 24 (44.6%) were G1b. Eight (4.8%) patients were cirrhotic; 7 Child-Pugh A, 1 Child-Pugh B-C. In 92 (48%), a liver biopsy was available: mean histologic activity index (HAI) was 7.5 and fibrosis score was 2.4. HAI was mild (1-6) in 35.9%, moderate (7-12) in 60.8%, and severe (13-14) in 3.3%. Fibrosis was mild in 54.4%, moderate in 43.3%, and advanced in 2.3%. 19(11.8%) patients were treatment–experienced (relapse 14, non-responder 5): pegylated-interferon+ribavirin (PR) in 16 (84.2%), PR+Boceprevir in 2 (10.5%), and PR+Telaprevir in 1 (%5.3). Viral response rates at treatment week 4, at the end of treatment and at SVR12 were 87% (47/54), 98.7% (76/77), and 98.6% (71/72) respectively. At SVR12 mean ALT 18 IU/mL, AST 21 IU/mL, albumin 4.2 g/dL, and prothrombin time 12.4 sec. DAAs were generally well tolerated. On treatment; 11 patients (6.5%) experienced adverse events: insomnia 5 (3.0%), asthenia 4 (2.4%), pruritus 3 (1.8%), headache 2 (1.2%), weight gain 2 (1.2%), and miscellaneous 5 (3.0%). CONCLUSION: Compared to all of the other patients in the database, IDUs were younger (58±12 years vs. 31±10 years, p<0.001) and the rate of male/female was higher (950 male-42.6%/1111 female-57.4% vs.159 male-%94.1/10 female-5.9%, p<0.001). Cirrhosis frequency was lower (303/2061; 14.7% vs.8/169; 4.8%, p<0.05). The majority of genotypes among other patients G1 is 92% and G2 plus G3 are 8%. However among IDUS, rate of G3 is 47.6%, G1: 32.1%, and G2: 10.1%. IDUs with HCV were shown to younger, higher rate of male gender, and with less severe liver disease. DAAs were found efficacious and safe in this group. *This study was supported by Gilead Sciences, 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 61-62
DOI 10.5152/tjg.2019.39
History
Published Online July 25, 2019
Copyright
Copyright (c) 2019 Fehmi Tabak, Behice Kurtaran, Esra Zerdali, Selma Tosun, Şaban Esen, Nefie Çuvalcı Öztoprak, Kamuran Türker, Nagehan Didem Sarı, Yusuf Önlen, Tansu Yamazhan, Kenan Hızel, Hepcturkey Study Group
Affiliations
Fehmi Tabak
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Behice Kurtaran
Cukurova University Faculty of Medicine Department of Infectious Diseases Adana Turkey
Esra Zerdali
Haseki Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Selma Tosun
Bozyaka Training and Research Hospital Infectious Diseases Department İzmir Turkey
Şaban Esen
19 Mayıs University Faculty of Medicine Infectious Diseases Department Samsun Turkey
Nefie Çuvalcı Öztoprak
Antalya Training and Research Hospital Infectious Diseases Department Antalya Turkey
Kamuran Türker
Bağcılar Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Nagehan Didem Sarı
Istanbul Training and Research Hospital Department of Infectious Diseases İstanbul Turkey
Yusuf Önlen
Mustafa Kemal University Faculty of Medicine Infectious Diseases Department Hatay Turkey
Tansu Yamazhan
Ege University Faculty of Medicine Infectious Diseases Department İzmir Turkey
Kenan Hızel
Gazi University Faculty of Medicine Infectious Diseases Department Ankara Turkey
Hepcturkey Study Group
Istanbul University Faculty of Medicine Infectious Diseases Department İstanbul Turkey
Cite this Article
Tabak, F., Kurtaran, B., Zerdali, E., Tosun, S., Esen, Şaban, Çuvalcı Öztoprak, N., … Group, H. S. (2019). Direct acting antivirals are effective and safe in intravenous drug users with chronic HCV Preview of your abstract file infection: First report from Turkey. Turkish Journal of Gastroenterology, 30(Supplement 1), 61–62. https://doi.org/10.5152/tjg.2019.39
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