MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A report from the Institute for Safe Medication Practices based on FDA data and observations from a Kaiser Permanente physician leader raised questions about whether direct acting antiviral medications for the treatment of Hepatitis C posed any significant safety risks for patients. Since the decision to take medications requires making tradeoffs between benefits (which had been clearly established in clinical trials) and risks (which are often harder to ascertain until drugs are in widespread use in the real world) we decided this was an important question to pursue. We found no evidence of increased risks of significant side effects associated with taking these drugs. In this cohort study of 33,808 patients in three large health systems we found lower adjusted odds of experiencing the following adverse events: death, multiple organ failure, hepatic decompensation, acute-on-chronic liver event, and arrhythmia.
MedicalResearch.com: What should readers take away from your report?
Scientists from Trinity College Dublin have discovered how the highly infectious and sometimes deadly Hepatitis C virus (HCV) “ghosts” our immune system and remains undiagnosed in many people. They report their findings today [Wednesday June 5th] in the international FASEB journal.
HCV’s main route of transmission is via infected blood but over the past 40 years it has accidentally been given to many patients across the world via infected blood products. The virus replicates particularly well in the liver, and the damage it causes makes it a leading cause of liver disease worldwide.
Even though HCV can be deadly, initial infection is rarely accompanied by any obvious clinical symptoms for reasons that have – until now – remained unknown. As a result, it often goes undiagnosed for the first 6-12 months following infection.
Clinicians need to consider the significant differences in the frequency of contraindicated drug-drug interactions (XXDIs) between various hepatitis C virus (HCV) treatment regimens, with a greater number of medications and longer duration of HCV infection being predictors of XXDIs, according to a cross-sectional study published in the Annals of Hepatology.1
There are currently 4 regimens that are recommended for treating HCV infection, including glecapravir/pibrentasvir (GLE/PIB), grazoprevir/elbasvir (GZR/EBR), lediprasvir/sofosbuvir (LDV/SOF), and sofosbuvir/velpatasvir (SOF/VEL).2-6 While each has demonstrated impressive rates of sustained virologic response in treatment recipients with low toxicity,7-11 limited comparative data exist evaluating the potential risk for XXDIs between these regimens.
One of the terrible consequences of Tennessee’s opioid crisis is the rise in hepatitis C infections.
Approximately 70,000 of our fellow Tennesseans are infected with the hepatitis C virus. Tragically, nearly half don’t even know they’re infected.
Between 2006 and 2012, the U.S. Centers for Disease Control and Prevention reported that there was an astonishing 364% jump in hepatitis C infections throughout central Appalachia, including Tennessee. Until recently, hepatitis C disproportionately affected baby boomers, but due to the nation’s opioid crisis, emerging health threats like hepatitis C have extended their reach to a broader population.
Researchers performed an integrated analysis of registrational studies utilizing the pangenotypic direct-acting antivirals (DAA) regimen of glecaprevir and pibrentasvir (G/P) to report adherence, effectiveness, safety and patient-reported outcomes (PROs) among patients with chronic hepatitis C virus (HCV) genotypes 1-6 infection with compensated liver disease (with or without cirrhosis) receiving G/P for 8, 12 or 16 weeks. They identified 2,522 patients who were receiving G/P; of these, 789 (31%) had a psychiatric disorder with the most common diagnoses being depression (64%; 506/789) and anxiety disorders (27%; 216/789). Patients with psychiatric disorders continuously displayed sustained virologic response at post-treatment week 12 rates >96% across individual psychiatric diagnoses and co-medication classes. Findings suggest that patients with chronic HCV infection and psychiatric disorders demonstrate high efficacy and good-tolerability for G/P treatment in addition to high adherence rates.