Effectiveness of Treatment of Chronic Viral Hepatitis C by Direct-Acting Antivirals in Togo
- 1 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
- 2 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
- 3 Hepatogastroenterology Unit, University Hospital of Kara, Kara, Togo
- 4 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
- 5 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
- 6 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
- 7 Hepatogastroenterology Unit, University Hospital Campus, Lomé, Togo
Abstract
Background: Viral hepatitis C is the second leading cause of hepatocellular carcinoma after hepatitis B in Africa and Togo in particular. The advent of direct acting antivirals has revolutionized the care and prognosis of patients infected with hepatitis C virus (HCV). Objective: To evaluate the sustained virological response (SVR) 12 weeks after oral treatment without interferon in HCV infected patients with genotypes 1 and 2. Patients and Method: Descriptive and analytical study based on the retrospective collection of data in the hepatogastroenterology unit of the University Hospital Campus of Lome (Togo) from July 11, 2016 to April 22, 2018. All patients who had a chronic viral hepatitis C with viral replication, naive, regardless of the genotype, regardless of the degree of liver fibrosis, and who had completed their treatment with direct-acting antivirals were included. Results: We recruited 84 patients, 60 of whom were infected with HCV genotype 2 (71.43%) and 24 with HCV genotype 1 (28.57%). There were 58 men and 26 women (sex ratio: 0.45). In HCV genotype 1 patients, the median age was 54.29 years and Sofosbuvir/Ledipasvir was the most used combination (62.50%). In HCV genotype 2 patients, the median age was 54.5 years and Sofosbuvir associated with Ribavirin was the most used treatment (81.66%). The virological response at the end of treatment was 100% (genotype 1) and 93.30% (genotype 2). The SVR 12 was 100% (genotype 1) and 91.70% (genotype 2). Five patients were in treatment failure (genotype 2). Conclusion: Direct-acting antivirals were effective in our patients. The rate of sustained virological response was above 90%.
- Lavanchy, D. (2011) Evolving Epidemiology of Hepatitis C Virus. Clinical Microbiology and Infection, 17, 107-115. https://doi.org/10.1111/j.1469-0691.2010.03432.x
- Madhava, V., Burgess, C. and Drucker, E. (2002) Epidemiology of Chronic Hepatitis C Virus Infection in Sub-Saharan Africa. The Lancet Infectious Diseases, 2, 293-302. https://doi.org/10.1016/S1473-3099(02)00264-5
- Mohd Hanafiah, K., Groeger, J., Flaxman, A.D. and Wiersma, S.T. (2013) Global Epidemiology of Hepatitis C Virus Infection: New Estimates of Age-Specific Antibody to HCV Seroprevalence. Hepatology, 57, 1333-1342. https://doi.org/10.1002/hep.26141
- Yousra, A.M., Ghina, R.M., Riome, S., De Wolfe, M. and Laith, J.A.-R. (2013) The Epidemiology of Hepatitis C Virus in Egypt: A Systematic Review and Data Synthesis. BMC Infectious Diseases, 13, 288. https://doi.org/10.1186/1471-2334-13-288
- Bagny, A., Bouglouga, O., Djibril, M., Lawson, A., Kaaga, Y.L., Sama Hamza, D., et al. (2013) Knowledge, Attitudes and Practices Relative to the Risk of Transmission of Hepatitis B and C Viruses in a Hospital in Togo. Médecine et Santé Tropicales, 23, 300-303.
- Kirk, G.D., Lesi, O.A., Mendy, M., Akano, A.O., Sam, O., Goedert, J.J., et al. (2004) The Gambia Liver Cancer Study: Infection with Hepatitis B and C and the Risk of Hepatocellular Carcinoma in West Africa. Hepatology, 39, 211-219. https://doi.org/10.1002/hep.20027
- Wai, C.T., Greenson, J.K., Fontana, R.J., Kalbfleisch, J.D., Marrero, J.A., Conjeevaram, H.S., et al. (2003) A Simple Noninvasive Index Can Predict Both Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C. Hepatology, 38, 518-526. https://doi.org/10.1053/jhep.2003.50346
- Sterling, R.K., Lissen, E., Clumeck, N., Sola, R., Correa, M.C., Montaner, J., et al. (2006) Development of a Simple Noninvasive Index to Predict Significant Fibrosis in Patients with HIV/HCV Coinfection. Hepatology, 43, 1317-1325. https://doi.org/10.1002/hep.21178
- Reddy, K., Bourlière, M., Sulkowski, M., Omata, M., Zeuzem, S., Feld, J.J., et al. (2015) Ledipasvir and Sofosbuvir in Patients with Genotype 1 Hepatitis C Virus Infection and Compensated Cirrhosis: An Integrated Safety and Efficacy Analysis. Hepatology, 62, 79-786. https://doi.org/10.1002/hep.27826
- Backus, L., Belperio, P., Shahoumian, T.A., Loomis, T. and Mole, L. (2015) Effectiveness of Ledipasvir/Sofosbuvir in Treatment Naïve Genotype 1 Patients Treated in Routine Medical Practice. Hepatology, 62, 255A.