Displaying publications 21 - 40 of 44 in total

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  1. Rafique G, Bukhsh A, Gul A, Khiljee S, Ashraf M, Omer MO
    Pak J Pharm Sci, 2017 Jan;30(1):11-16.
    PMID: 28603106
    180 million people are affected by chronic Hepatitis C Virus infection globally and more than 50 million in South East Asia. Combination of Interferon and Ribavirin is the current anti-HCV therapy in practice and is associated with certain hematologic adverse effects. In this concurrent observational study the incidence rate of major hematologic adverse effects and efficacy outcomes of Interferon and Ribavirin combination therapy was evaluated in 288 chronic hepatitis C patients at Lahore General Hospital. Levels of Hb, TLC, and Platelets counts were monitored for hematologic adverse effects monitoring, whereas, ALT, AST and bilirubin levels were monitored for efficacy. PCR was done at week 4, 12 &36 for therapeutic success evaluation. A significant reduction in Hb levels (p<0.05) was observed after week 4, 8 and 12 of therapy. Frequency of anemia increased in both genders with body weight <65kg and platelet count <150,000/mm(3). End Treatment Response (ETR) was achieved in 64.5%. Anemia was the major side effect of the combination therapy particularly in the males. Higher ETR was observed in patients who achieved RVR and were <50 years of age.
    Matched MeSH terms: Hepatitis C, Chronic/blood; Hepatitis C, Chronic/diagnosis; Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/epidemiology
  2. Naing C, Sitt T, Aung AT, Aung K
    Medicine (Baltimore), 2015 Jul;94(30):e1234.
    PMID: 26222859 DOI: 10.1097/MD.0000000000001234
    In Myanmar, hepatitis C virus (HCV) infection prevalence is 2%. A combination therapy of pegylated interferon alfa-2a and ribavirin (PEG-IFNa/RBV) is a standard treatment, but the effect of this antiviral therapy needs evaluation as to determine the efficacy and safety of dual PEG-IFNa/RBV therapy in treating patients infected with HCV in Myanmar.This was a retrospective analysis of data from a single clinic exclusively for gastrointestinal diseases in Yangon, Myanmar. We assessed treatment responses at the defined time points and stratified by genotypes of HCV. We also determined incidences of adverse events (AEs). We investigated independent predictors of sustained virologic response (SVR) in the participants.A total of 362 HCV-infected cases were included in this study. The majority were females (51.7%) with mean age of 47.12 years (±11.6) and noncirrhosis patients (82%). Rapid virologic response (RVR), early virologic response (EVR), end of treatment response (ETR), and SVR 24 weeks after completion of the dual treatment were 50.3% (178/362), 88% (314/357), 80.1% (286/357), and 85.6% (167/195), respectively. The most frequently reported AEs were nausea/anorexia (72.8%) and flu-like symptoms (62.4%). In multivariate analysis, 4 factors were independently associated with SVR; SVR to genotype 3 (odds ratio [OR] 2.4, 95% CI: 1.24-4.62), EVR (OR 0.54, 95% CI: 0.3-0.95), and duration of treatment (OR 1.52, 95% CI: 1.18-1.98). Study limitations were acknowledged.The efficacy and safety of the dual therapy in treating HCV-infected patient in Myanmar was acceptable. We recommend a prospective randomized control trial looking at duration of therapy and rates of achieving SVR, which could significantly impact the care of HCV-infected patients in Myanmar and perhaps other countries as well.
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/virology
  3. Abd El-Maksoud E, Salem AM, Maher AM, Hegazy MGA
    Trop Biomed, 2020 Dec 01;37(4):1083-1092.
    PMID: 33612760 DOI: 10.47665/tb.37.4.1083
    HCV genotype 4 dominates the HCV epidemic in Egypt. Drug resistance was the most serious side effect that reflects bad clinical outcome. Several studies had demonstrated that baseline serum interferon-γ-inducible-protein 10 (IP-10) levels and interleukin 28B polymorphisms were associated with the resistance to the standard of care pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy and development of post-treatment relapse. Our purpose was to assess the predictive value of combining IP-10 levels and IL28B genotypes to PEG-IFNα/RBV therapy response in Egyptian chronic HCV infection patients with genotype 4. Ninety Egyptian patients chronically infected by HCV genotype-4 treated with pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy were enrolled. Serum IP-10 levels were determined by enzyme linked immunosorbent assay pre- and post- treatment. IL-28B (rs12979860 and rs8099917) polymorphisms were performed by PCR-RFLP in all patients. Overall, 38 patients (42.2%) achieved sustained virologic response (SVR) and 52 (57.8%) patients have non-viral response (NVR). Pretreatment serum IP-10 mean levels were significantly lower in patients who achieved SVR than in NVR (P<0.05). CC genotype in IL28B polymorphism (rs12979860) was the favorable genotype as 65.8% achieved SVR, while TT genotype in IL-28B polymorphism (rs8099917) was the favorable genotype as 81.5% achieved SVR. Baseline IP-10 was significantly correlated to genotypes CC in rs12979860 and TT in rs8099917. Combined use of serum baseline IP-10 levels with IL-28B polymorphisms could improve the prediction of SVR to PEG-IFNα/RBV therapy in Egyptian chronic HCV infection patients with genotype 4.
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/genetics
  4. Tan SS, Adlin Nadia Z
    Med J Malaysia, 2017 06;72(3):165-174.
    PMID: 28733564 MyJurnal
    AIM: To describe the clinical characteristic of hepatitis C (HCV) patients and the results of pegylated interferon and ribavirin (PegIFN/RBV) therapy in a routine clinical practice.

    METHODS: A retrospective review of consecutive HCV patients treated with PegIFN/RBV in 2004 to 2012.

    RESULTS: A total of 273 patients received treatment. The mean age was 44.16 ± 10.5 years and 76% were male. The top 2 self-reported risks were blood or blood product transfusion before 1994 and injection drug use, found in 57.1% of patients. The predominant HCV genotype (GT) was 3 at 60.6%, second was GT1 at 36.1% and other GTs were uncommon at about 1% or less. About half of our patients have high baseline viral load (>800,000 iu/ml), 18.3% had liver cirrhosis and 22.3% had HIV co-infection. Co-morbid illness was found in 42.9%, hypertension and type 2 diabetes were the two most common. The overall sustained virological response (SVR) by intention-to-treat analysis were 54.9% (n=150/273), 41.2% (40/97) for GT1, 100% (5/5) for GT2 and 62% (101/163) for GT3. Subgroup analysis for HCV monoinfected, treatment naïve showed SVR of 49.2% (31/63) for GT1, 100% (5/5) for GT2 and 67% (69/103) for GT3. In HCV mono-infected and treatment experienced (n=29), the SVR was 28.6% (4/14) for GT1, 21.4% (69/103) for GT3. In the HIV/HCV co-infected, treatment naïve (n=56), the SVR was 28.6% (4/14) for GT1 and 64.3% (27/42) for GT3. Treatment naïve GT3 mono-infected patients had a statistically significant higher SVR compared to treatment experienced patients (P=0.001). In GT3 patients who achieved rapid virological response, the SVR was significantly higher at 85.2% (P< 0.001). The SVR for cirrhotics were low especially for GT1 at 21% (4/19) and 31% (4/13) based on all patients and treatment naïve HCV monoinfected respectively. In GT3 cirrhotics the corresponding SVR were 57.1% (16/28) and 60.9% (14/23). Premature discontinuation rate was 21.2% with the majority due to intolerable adverse events at 12.1%.

    CONCLUSIONS: In our routine clinical practice, the HCV patients we treated were young, predominantly of GT3 and many had difficult-to-treat clinical characteristics. The SVR of our patients were below those reported in Asian clinical trials but in keeping with some "real world" data.

    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/pathology
  5. Bee Keng Law, Euginie Tracy Wong, Qiao Wei Liew, Zhi Sam Heng
    MyJurnal
    Introduction: Hepatitis C virus (HCV) is a worrying public health issue worldwide. The introduction of direct-acting antiviral agents (DAAs) brings revolution to HCV treatment. Pharmacists’ role in Malaysia is significant since the implementation of Medication Therapy Adherence Clinic (MTAC). This study aims to determine the sustained virological response (SVR12) for HCV patients treated with Sofosbuvir and Daclatasvir and/or Ribavirin. Besides, it evaluates adherence rate, types of pharmaceutical intervention and physicians’ acceptance rate.
    Matched MeSH terms: Hepatitis C, Chronic
  6. Poddar, Sandeep
    MyJurnal
    Hepatitis C is a liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis infection. Patients with chronic hepatitis C virus (HCV) infection appear to have an excellent chance of responding to 6 months of standard therapy with interferon (IFN) and frequently develop systemic iron overload, which exacerbates morbidity. The iron excess in hepatitis C may be due to hereditary hemochromatosis, hematologic diseases, multiple transfusions, porphyria cutanea tarda and chronic alcohol abuse. Different mechanisms proposed to explain the relation between HCV infection and hepatic iron overload. Some revealed that hepatic iron accumulation results from release of iron from damaged liver cells. Consumption of coffee, tea also reduces iron absorption and thereby decrease iron overload in Liver and thereby reduces the oxidative stress of iron overload in liver. The global scenario of this problem has been discussed in the article.
    Matched MeSH terms: Hepatitis C, Chronic
  7. Kowdley KV, Sundaram V, Jeon CY, Qureshi K, Latt NL, Sahota A, et al.
    Hepatology, 2017 04;65(4):1094-1103.
    PMID: 28027579 DOI: 10.1002/hep.29005
    Eight weeks duration of ledipasvir/sofosbuvir (LDV/SOF) can be considered in genotype 1 hepatitis C virus-infected patients who are treatment-naive, do not have cirrhosis, and have a pretreatment viral load <6,000,000 IU/mL. The effectiveness of this regimen, however, has not been fully confirmed by real-world experience. Using data from real-world cohorts, we aimed to determine the effectiveness of 8 weeks of LDV/SOF treatment, examine variables associated with relapse after treatment with this regimen, and compare the effectiveness of 8 weeks and 12 weeks of LDV/SOF treatment. To evaluate the effectiveness of 8 weeks of therapy and characteristics associated with relapse, we used individual patient data from the IFI (Institut für Interdisziplinäre Medizin), Burman's Pharmacy, and Kaiser Permanente Southern California. All patients had fibrosis staging assessed with biopsy, transient elastography, or serum biomarkers. We also performed a systematic review and meta-analysis of six additional real-world cohorts, to compare effectiveness of 8 weeks to 12 weeks duration. In our pooled data analysis, 634 patients were treated for 8 weeks with LDV/SOF, of whom all had outcomes of cure or relapse without loss to follow-up. Per protocol rates of sustained virologic response at 12 weeks were 98.1% (622/634) in the full cohort and 97.9% (571/583) among treatment-eligible patients. Exact logistic regression revealed no specific patient characteristics associated with relapse. Our meta-analysis of six additional real-world cohorts, comprised of 5,637 patients, demonstrated similar risk for relapse between 8 weeks and 12 weeks of LDV/SOF (relative risk = 0.99, 95% confidence interval 0.98-1.00).

    CONCLUSION: An 8-week duration of treatment with LDV/SOF is highly effective in properly selected patients; greater use of this regimen is recommended. (Hepatology 2017;65:1094-1103).

    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/genetics; Hepatitis C, Chronic/pathology
  8. Manns M, Zeuzem S, Sood A, Lurie Y, Cornberg M, Klinker H, et al.
    J Hepatol, 2011 Sep;55(3):554-563.
    PMID: 21237227 DOI: 10.1016/j.jhep.2010.12.024
    BACKGROUND & AIMS: There is increasing interest in identifying patients with chronic hepatitis C genotype 2 or 3 infection in whom it is possible to lower the burden of therapy while retaining high levels of efficacy.

    METHODS: Treatment-naive patients with chronic hepatitis C genotype 2/3 infection were randomized to receive peginterferon alfa-2b (1.5μg/kg/wk) for 24weeks (group A); peginterferon alfa-2b (1.0μg/kg/wk) for 24weeks (group B); or peginterferon alfa-2b (1.5μg/kg/wk) for 16weeks (group C), each in combination with weight-based ribavirin (800-1200mg/d). The study population comprised two cohorts: the Hep-Net cohort enrolled in Germany and an International cohort enrolled at study sites throughout Europe and Asia. The primary end point was sustained virological response (SVR).

    RESULTS: The study included 682 patients; 80.2% had genotype 3 infection. In the intent-to-treat population, SVR rates were 66.5%, 64.3%, and 56.6% in groups A, B, and C, and were similar in Asian and white patients. Treatment differences (A vs. B and A vs. C) failed to reach the predefined margin for noninferiority of -10%; and thus groups B and C failed to show noninferiority relative to group A. Among patients with undetectable HCV RNA at week 4, SVR rates were 75.3%, 75.9%, and 72.4%, respectively. Relapse rates were 17.8%, 16.3%, and 29.3%, respectively. Treatment-emergent serious adverse events were highest in group A and lowest in group C, and adverse events leading to discontinuation were similar across treatment arms.

    CONCLUSIONS: For patients with chronic hepatitis C genotype 2/3 infection, 24weeks of peginterferon alfa-2b (1.5μg/kg/wk) plus weight-based ribavirin remains a standard-of-care therapy; however, treatment for 16weeks may be considered for patients with undetectable HCV RNA at week 4 of the treatment.

    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/ethnology; Hepatitis C, Chronic/virology*
  9. Hassan MR, Mustapha NR, Zawawi FM, Earnest BS, Voralu K, Pani SP
    Singapore Med J, 2011 Feb;52(2):86-9.
    PMID: 21373733
    This study was conducted to compare the genotype and markers of disease severity of chronic hepatitis C (CHC), namely viral load, alanine transaminase (ALT) levels and histopathological findings on liver biopsy, in patients with and without end-stage renal disease (ESRD).
    Matched MeSH terms: Hepatitis C, Chronic/blood; Hepatitis C, Chronic/diagnosis*; Hepatitis C, Chronic/genetics
  10. Seow EL, Robert Ding PH
    Med J Malaysia, 2005 Dec;60(5):637-41.
    PMID: 16515116
    This was an open-label, uncontrolled study with the aim of assessing the efficacy and safety of pegylated interferon alfa-2b plus ribavirin in the treatment of chronic hepatitis C. The study was conducted in Island Hospital, Penang beween January 2002 and December 2003. Thirty-three patients were enrolled in this study with ten defaulters. The overall sustained virological response (SVR) (Intention-To-Treat analysis) in naïve patients was 39.10%. However, when the study was adjusted to only include those who completed treatment and follow-up, overall SVR as 52.9%. Side-effects were tolerable in most patients with anaemia occurring in 22 patients (66.7%), leukopenia 23 patients (69.7%) and thrombocytopenia in 15 patients (45.5%). This study showed that pegylated interferon alfa-2b 1.5 mcg/kg/week plus ribavirin > 10.6 mg/kg/day is efficacious and safe to be used in the treatment of: chronic hepatitis C.
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*
  11. Elbanan WK, Fathy SA, Ibrahim RA, Hegazy MGA
    Trop Biomed, 2020 Dec 01;37(4):1093-1104.
    PMID: 33612761 DOI: 10.47665/tb.37.4.1093
    Hepatitis C virus (HCV) infection in Egypt is the most serious health problem. Identifying HCV-positive persons at high risk of early complications can help prioritize treatment decisions. Recently, attention has been directed to non-invasive, accurate alternatives using serum biochemical markers. The transforming growth factor β 1/interleukins pathway plays an important role in the process of cell injury and inflammation. Thus, TGF-β1 and IL-17 were assessed in serum of chronic HCV patients with correlation to hepatic inflammatory and fibrotic status. The quantitative serum levels of TGF-β1 and IL-17 were analyzed among chronic hepatitis C (CHC) patients (n=75) and normal control (NC) subjects (n=15). Disease severity in patients was assessed using the Child-Pugh scores and METAVIR. Serum levels of TGF-β1 and IL-17 were significantly increased in HCV patients compared to control group. Furthermore, the levels of TGF-β1 and Il-17 were positively correlated to serum transaminases and alpha-fetoprotein and they were negatively correlated with serum albumin and platelets. Additionally, the serum levels of TGF-β1 and Il-17 were associated with inflammation grades and stages of liver fibrosis. TGF-β1 and IL-17 may be hopeful serum biomarkers concerned in the progression of liver inflammation and fibrosis accompanying chronic HCV infection. Therefore, they could be used in the future as targets for anti-fibrotic therapy of chronic HCV to ameliorate the disease progress.
    Matched MeSH terms: Hepatitis C, Chronic/diagnosis*
  12. Earnest BS, Men LC, Sukvinder Kaur G, Alias RB, Sunita Devi H
    J Assoc Physicians India, 2010 Feb;58(2):118-20.
    PMID: 20653157
    The neurological manifestations of chronic hepatitis C is most often a peripheral sensory neuropathy characterised by numbness, burning and sensation of "pins and needles". Peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex and transverse myelitis also occur. Ischemic stroke and transient cerebral ischemia have also been reported. Anterior ischemic optic neuropathy is seen, often following interferon therapy. We report an exceptional case of neuromyelitis optica in chronic hepatitis C infection in the absence of interferon therapy.
    Matched MeSH terms: Hepatitis C, Chronic/complications*
  13. Sukeepaisarnjaroen W, Pham T, Tanwandee T, Nazareth S, Galhenage S, Mollison L, et al.
    World J Gastroenterol, 2015 Jul 28;21(28):8660-9.
    PMID: 26229408 DOI: 10.3748/wjg.v21.i28.8660
    To examined the efficacy and safety of treatment with boceprevir, PEGylated-interferon and ribavirin (PR) in hepatitis C virus genotype 1 (HCVGT1) PR treatment-failures in Asia.
    Matched MeSH terms: Hepatitis C, Chronic/complications; Hepatitis C, Chronic/diagnosis; Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/ethnology
  14. Tan SS, Abu Hassan MR, Abdullah A, Ooi BP, Korompis T, Merican MI
    J Viral Hepat, 2010 Jun;17(6):410-8.
    PMID: 19758272 DOI: 10.1111/j.1365-2893.2009.01191.x
    Chronic hepatitis C is associated with increased morbidity and mortality in persons undergoing haemodialysis. This single-arm, open-label clinical trial investigated the safety and efficacy of an escalating dosage regimen of pegylated interferon (PEG-IFN) alpha-2b in this patient population. Patients with chronic hepatitis C who were undergoing haemodialysis began treatment with PEG-IFN alpha-2b at a dose of 0.5 microg/kg/week, which was increased every 4 weeks to a maximum of 1 microg/kg/week. Treatment duration was 24 weeks for patients with genotype (G) 2 or 3 infection and 48 weeks for patients with G1 infection. The primary end point was sustained virological response (SVR). Of 46 patients screened, 34 (G1: 70.6%; G3: 29.4%) were treated and 23 (67.6%) completed treatment. Overall, 85.3% of patients experienced early virological response, 52.9% experienced end-of-treatment response, and 50% attained SVR, with a trend toward higher SVR rates in G3 compared with G1 patients (80%vs 37.5%; P = 0.06). Anaemia was the main reason for discontinuation of treatment. Patients with chronic hepatitis C who are undergoing haemodialysis can be successfully treated with an escalating dosage regimen of PEG-IFN alpha-2b monotherapy. G3-infected patients can attain high rates of SVR with only 24 weeks of therapy.
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*
  15. Chuah YY, Lee YY, Chen WC, Kao SS
    Acta Gastroenterol Belg, 2018 10 24;81(3):447-448.
    PMID: 30350541
    Matched MeSH terms: Hepatitis C, Chronic/complications
  16. Azline Abdilah, Sri Ganesh Muthiah, Hayati Kadir
    MyJurnal
    Introduction: Hepatitis C virus (HCV) infection is known as contributing to high morbidity and mortality globally. Major liver complications such as liver failure and liver cancer which can lead to fatality have been associated with persistent HCV infection. Globally, it is estimated that 5.6 million chronically infected HCV are among people who inject drugs (PWID). Malaysia has estimated that 59% HCV infections were among PWID. The aim of this study is to determine the prevalence of HCV infection and its predictors among PWID in Negeri Sembilan. Methods: A cross-sectional study based on random proportion to size sampling was conducted among 212 out of 1414 regis- tered Methadone Maintenance Therapy (MMT) clients with PWID attending health clinics in Negeri Sembilan from February 2018 to July 2018. Data were collected using questionnaires administered through face-to-face interviews. Data were analyzed using Statistical Package of IBM SPSS Statistics Version 23 and p-value of
    Matched MeSH terms: Hepatitis C, Chronic
  17. Hasni Mahayidin, Siti Zulaikha Zakariah, Noor Ashidah Ishah, Xu Ann Wee, Masita Arip, Nurhanani Mohamed Nor
    MyJurnal
    Introduction: Diabetes-associated autoantibodies (DAA) is the hallmark of T1DM and LADA which are frequently tested in young diabetes patients. It was noted that up to 10-15% of patients with initial diagnosis of T2DM also exhibit DAA. Regardless of the classification, the presence of DAA suggests an underlying islet autoimmunity which lead to progressive pancreatic β-cell failure. There is limited data reported on DAA in young diabetes patients in Malaysia. This study aims to determine the frequency of DAA positivity and its association with demographic and clinical characteristics among this cohort. Methods: A retrospective study using secondary data obtained from Al- lergy and Immunology Research Centre, Institute for Medical Research, Malaysia. This study included 194 diabetes patients who were diagnosed before the age of 40 years old and tested for GADA, ICA, IA2A and IAA. Results: From 194 patients, 91 (46.9%) were positive for least one of the following DAA: ICA (79, 40.7%), GADA (61, 31.4%), IA2A (37, 19.1%) and IAA (9, 4.6%). Multiple positivity was higher (73.6%) compared to single positivity. Highest com- bination of double positivity was ICA+GADA (54, 59.3%) and triple positivity was ICA+GADA+IA2A (25, 27.5%). Simultaneous positivity of four autoantibodies was seen in only one (1.1%) patient. ICA, GADA and IA2A were asso- ciated with age group and ethnicity (all p < 0.001). Only IA2A was associated with gender (p = 0.012). Conclusions: GADA, ICA ad IA2A are more significant in young Malaysian diabetes patients. IAA has a very low frequency in this studied population.

    Matched MeSH terms: Hepatitis C, Chronic
  18. Noor Annisa Darman, Muhammad Adib Abd Wahab, Wan Nur Illyana Wan Yusoff, Sasikala Siva, Xiao Hui Sem, Jessica Markby
    MyJurnal
    Introduction:Despite significant advancements in testing technologies and treatment, 80% of 80 million chronically hepatitis C virus (HCV) infected people remain undiagnosed. FIND in collaboration with Ministries of Health and local partners, initiated seven Unitaid funded Hepatitis C Elimination through Access to Diagnostics (HEAD-Start) projects in four countries (Georgia, India, Malaysia and Myanmar) to demonstrate innovative models of HCV care to inform programme scale-up nationally and globally. Here, we describe preliminary findings for patient retention in the HCV cascade for each project. Methods: Target populations and settings include people who inject drugs (PWID) in harm reduction sites (Manipur, Georgia, Myanmar), high risk patients in primary health care facilities (Malaysia), general population in polyclinics and district hospitals (Delhi) and people living with HIV (PLHIV) in antiretroviral therapy (ART) clinics (Punjab). All projects employ rapid diagnostic tests for HCV screening. HCV seropositive patients received confirmatory testing either on site (Georgia, Myanmar) or via centralized laboratory (Malaysia, Georgia, Delhi) or testing hubs (Punjab, Manipur). Results: In Malaysia, 4,613 patients were screened - 23% (1,042) are HCV seropositive, 57% (594) received RNA confirmatory testing and 11% (54) confirmed RNA-positive initiated treatment. In Delhi, 17,101 patients were screened – 2% (355) are seropositive, 92% (326) received confirmatory testing and 70% (180) initiated treatment. In Punjab, 17,507 patients were screened – 19% (3,368) are seroposi-tive, 94% (3,165) received confirmatory testing and 31% (828) initiated treatment. In Manipur, 3,845 patients were screened - 56% (2,180) are seropositive, 73% (1,591) received confirmatory testing and 67% (823) initiated treat-ment. In Myanmar, 199 patients were screened – 96% (191) are seropositive, 100% received confirmatory testing and 86% (151) initiated treatment. In Georgia (Arm 1) - 100% (619) received confirmatory testing and 76% (389) initiated treatment. Conclusion: The fully decentralised HCV testing model demonstrated higher numbers of patients progressing to each step in the care cascade.
    Matched MeSH terms: Hepatitis C, Chronic
  19. Wong XZ, Gan CC, Mohamed R, Yahya R, Ganapathy S, Tan SS, et al.
    BMC Nephrol, 2020 11 13;21(1):480.
    PMID: 33187498 DOI: 10.1186/s12882-020-02154-4
    BACKGROUND: Hepatitis C virus (HCV) infects more than 71 million people worldwide and chronic HCV infection increases the risk of liver cirrhosis and failure. Haemodialysis (HD) is one of the renal replacement therapies with risk of HCV transmission. Anti-HCV antibodies are the serological screening test for HCV infection that does not detect active phase of infection. Majority HCV infected HD patients in Malaysia do not have further HCV RNA performed due to high cost and thus HCV treatment is less frequently offered. HCV Core Antigen (HCV Ag) can potentially be used to diagnose active HCV infection in HD population in comparison to HCV RNA, at lower cost.

    METHODS: We conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.

    RESULTS: We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04 ± 11.62 years, HD vintage of 14.1 ± 9.7 years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p  3000 IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p chronic active HCV infection among HD cohort, who can then be considered for HCV treatment. For seropositive HD patient with negative HCV Ag, we recommend to follow-up with HCV RNA test.

    Matched MeSH terms: Hepatitis C, Chronic
  20. Andrieux-Meyer I, Tan SS, Thanprasertsuk S, Salvadori N, Menétrey C, Simon F, et al.
    Lancet Gastroenterol Hepatol, 2021 Jun;6(6):448-458.
    PMID: 33865507 DOI: 10.1016/S2468-1253(21)00031-5
    BACKGROUND: In low-income and middle-income countries, affordable direct-acting antivirals are urgently needed to treat hepatitis C virus (HCV) infection. The combination of ravidasvir, a pangenotypic non-structural protein 5A (NS5A) inhibitor, and sofosbuvir has shown efficacy and safety in patients with chronic HCV genotype 4 infection. STORM-C-1 trial aimed to assess the efficacy and safety of ravidasvir plus sofosbuvir in a diverse population of adults chronically infected with HCV.

    METHODS: STORM-C-1 is a two-stage, open-label, phase 2/3 single-arm clinical trial in six public academic and non-academic centres in Malaysia and four public academic and non-academic centres in Thailand. Patients with HCV with compensated cirrhosis (Metavir F4 and Child-Turcotte-Pugh class A) or without cirrhosis (Metavir F0-3) aged 18-69 years were eligible to participate, regardless of HCV genotype, HIV infection status, previous interferon-based HCV treatment, or source of HCV infection. Once daily ravidasvir (200 mg) and sofosbuvir (400 mg) were prescribed for 12 weeks for patients without cirrhosis and for 24 weeks for those with cirrhosis. The primary endpoint was sustained virological response at 12 weeks after treatment (SVR12; defined as HCV RNA <12 IU/mL in Thailand and HCV RNA <15 IU/mL in Malaysia at 12 weeks after the end of treatment). This trial is registered with ClinicalTrials.gov, number NCT02961426, and the National Medical Research Register of Malaysia, NMRR-16-747-29183.

    FINDINGS: Between Sept 14, 2016, and June 5, 2017, 301 patients were enrolled in stage one of STORM-C-1. 98 (33%) patients had genotype 1a infection, 27 (9%) had genotype 1b infection, two (1%) had genotype 2 infection, 158 (52%) had genotype 3 infection, and 16 (5%) had genotype 6 infection. 81 (27%) patients had compensated cirrhosis, 90 (30%) had HIV co-infection, and 99 (33%) had received previous interferon-based treatment. The most common treatment-emergent adverse events were pyrexia (35 [12%]), cough (26 [9%]), upper respiratory tract infection (23 [8%]), and headache (20 [7%]). There were no deaths or treatment discontinuations due to serious adverse events related to study drugs. Of the 300 patients included in the full analysis set, 291 (97%; 95% CI 94-99) had SVR12. Of note, SVR12 was reported in 78 (96%) of 81 patients with cirrhosis and 153 (97%) of 158 patients with genotype 3 infection, including 51 (96%) of 53 patients with cirrhosis. There was no difference in SVR12 rates by HIV co-infection or previous interferon treatment.

    INTERPRETATION: In this first stage, ravidasvir plus sofosbuvir was effective and well tolerated in this diverse adult population of patients with chronic HCV infection. Ravidasvir plus sofosbuvir has the potential to provide an additional affordable, simple, and efficacious public health tool for large-scale implementation to eliminate HCV as a cause of morbidity and mortality.

    FUNDING: National Science and Technology Development Agency, Thailand; Department of Disease Control, Ministry of Public Health, Thailand; Ministry of Health, Malaysia; UK Aid; Médecins Sans Frontières (MSF); MSF Transformational Investment Capacity; FIND; Pharmaniaga; Starr International Foundation; Foundation for Art, Research, Partnership and Education; and the Swiss Agency for Development and Cooperation.

    Matched MeSH terms: Hepatitis C, Chronic/complications; Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/virology
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