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KMID : 0191120190340410264
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Journal of Korean Medical Science
2019 Volume.34 No. 41 p.264 ~ p.264
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Durability of Sustained Virologic Response and Improvement of Fibrosis Markers after Daclatasvir and Asunaprevir Treatment in Genotype 1b Hepatitis C Virus-Infected Patients: a Real Life and Multicenter Study
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Shin Seung-Kak
Lee Jin-Woo
Ra Han-Nah
Kwon Oh-Sang
Shin Jong-Beom
Jin Young-Joo
Lee Sang-Heun
Han Ki-Jun
Kim Young-Nam
Kim Tae-Hun
Kim Yun-Soo
Kim Ju-Hyun
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Abstract
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Background: The long-term data with direct acting antiviral agents were rare. This study investigated the durability of a sustained virologic response (SVR) and the improvement of fibrosis after daclatasvir and asunaprevir (DCV/ASV) treatment in genotype 1b (GT1b) hepatitis C virus (HCV)-infected patients.
Methods: A total of 288 HCV GT1b patients without baseline non-structural 5A (NS5A) resistance-associated substitution (RAS) treated with DCV/ASV were enrolled. Virologic response was measured at 12 weeks and 1 year after treatment completion. In cirrhotic patients, liver function, aspartate transaminase to platelet ratio index (APRI), FIB-4 index, fibrosis index (FI), and liver stiffness measurement (LSM) at baseline and 1 year after treatment completion were evaluated.
Results: SVR12 was obtained in 278 patients (96.5%). Six patients who checked NS5A RAS after treatment failure were RAS positive. Only one patient showed no durability of SVR. In cirrhotic patients who achieved SVR12 (n = 59), the changes of albumin (3.8 [2.2?4.7] to 4.3 [2.4?4.9] g/dL; P < 0.001), platelet count (99 [40?329] to 118 [40?399] × 103/mm3; P < 0.001), APRI (1.8 [0.1?14.8] to 0.6 [0.1?4.8]; P < 0.001), FIB-4 index (5.45 [0.6?32.8] to 3.3 [0.4?12.2]; P < 0.001), FI (5.5 [0.6?32.8] to 3.3 [0.4?12.2]; P < 0.001), and LSM (17.2 [5.3?48.0] to 11.2 [3.7?28.1] kPa; P = 0.001) between baseline and 1 year after treatment completion were observed.
Conclusion: DCV/ASV treatment for HCV GT1b infected patients without RAS achieved high SVR rates and showed durable SVR. Cirrhotic patients who achieved SVR12 showed the improvement of liver function and fibrosis markers.
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KEYWORD
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Asunaprevir, Daclatasvir, Fibrosis, Hepatitis C Virus, Sustained Virologic Response
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