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

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