Interferon-free treatment of chronic hepatitis C virus infection in patients with inherited bleeding disorders

Summary

Chronic hepatitis C virus (HCV) infection causes significant mortality in patients with inherited bleeding disorders, however, data of interferon-free antiviral regimes are scarce in this population. Patients, methods: Reallife data of interferon-free therapies of 18 patients with inherited bleeding disorders and chronic HCV genotype 1 infection (94% male, liver cirrhosis Child A/B n = 4/1). Results: Treatment naïve patients were treated for eight weeks with sofosbuvir (SOF)/ledipasvir (n = 3) or for 12 weeks with SOF/ledipasvir (n = 4), SOF/ledipasvir/ribavirin (n = 1), or paritaprevir/r, ombitasvir, dasabuvir (n = 1). Treatment experienced patients without cirrhosis received SOF/ledipasvir (n = 3) or paritaprevir/r, ombitasvir, dasabuvir ± ribavirin (n = 2) for 12 weeks. Re-treated cirrhotic individuals were treated for 24 weeks with SOF/ledipasvir (n = 2) and SOF/daclatasvir (n = 1), or for 12 weeks SOF/simeprevir/1200 mg/d ribavirin (n = 1). Sustained virologic response (SVR-12) was achieved by 17/18 individuals without severe on-treatment side effects. Conclusions: In real-life, HCV-infected patients with inherited bleeding disorders can be effectively and safely treated with interferon- free therapies.

Zusammenfassung

Eine chronische Hepatitis C Virusinfektion (HCV) ist für eine erhebliche Mortalität bei Patienten mit angeborenen Gerinnungsstörungen verantwortlich, Erfahrungen zu modernen Interferon-freien Behandlungsoptionen liegen bisher jedoch kaum vor. Patienten, Methoden: Zusammenfassung von 18 “reallife” Interferon-freien Behandlungen bei Patienten mit angeborenen Gerinnungsstörungen und chronischer HCV Genotyp 1 Infektion (94% männlich, Leberzirrhose Child A/B n = 4/1). Ergebnisse: Naïve Patienten wurden für acht Wochen behandelt mit Sofosbuvir (SOF)/Ledipasvir (n = 3) oder für 12 Wochen mit SOF/Ledipasvir (n = 4), SOF/Ledipasvir/Ribavirin (n = 1), oder Paritaprevir/r, Ombitasvir, Dasabuvir (n = 1). Vorbehandelte Patienten ohne Zirrhose erhielten für 12 Wochen SOF/Ledipasvir (n = 3) oder Paritaprevir/r, Ombitasvir, Dasabuvir ± Ribavirin (n = 2). Vorbehandelte Patienten mit Zirrhose wurden für 24 Wochen mit SOF/Ledipasvir (n=2) und SOF/Daclatasvir (n=1) oder für 12 Wochen mit SOF/Simeprevir/1200 mg/d Ribavirin (n=1) behandelt. Ein dauerhaftes virologisches Ansprechen (SVR-12) wurde bei 17/18 Patienten ohne schwerwiegende Nebenwirkungen erreicht. Schlussfolgerung: Patienten mit chronischer HCV-Infektion und angeborenen Gerinnungsstörungen können effektiv und sicher mit Interferon-freien Strategien behandelt werden.

Keywords

Sofosbuvir - ledipasvir - daclatasvir - simeprevir - paritaprevir

Schlüsselwörter

Sofosbuvir - Ledipasvir - Daclatasvir - Simeprevir - Paritaprevir

 

Conflict of interest

JW has served as a speaker, a consultant, and an advisory board member for AbbVie, BMS, Boehringer, Gilead, Janssen, Roche, and Siemens, and has received research funding from Siemens and Glaxo-SmithKline.

IS has received unrestricted research grants from MSD, Jansen, AbbVie, Takeda, and Gilead, and served as a consultant/advisory board member for Shire, Baxter, Dr. Falk Pharma, AbbVie, Fresenius, Intercept Pharma. He served as a speaker for Shire, Baxter, Dr. Falk Pharma, AbbVie, and Fresenius.

KS has served as speaker or advisory board member for AbbVie, BMS, Gilead, and Janssen.

TB has served as a speaker, a consultant, and an advisory board member for AbbVie, BMS, Boehringer, Gilead, Janssen,Merck, Novartis, Roche, and Vertex Pharmaceuticals Incorporated, and has received research funding from Gilead, Janssen, Novartis, and Roche.

UK has served as a speaker and an advisory board member for AbbVie, BMS, Gilead, Janssen, and Roche.

KE has nothing to disclose.

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