Treatment of HCV genotype 2 infection

Česká verzia

Authors: Petr Husa; Petr Husa Jr
Authors place of work: Klinika infekčních chorob LF MU a FN Brno, pracoviště Bohunice
Published in the journal: Vnitř Lék 2017; 63(1): 37-40
Category: Original Contributions

Summary

Introduction:
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide.

Aims:
Retrospectively evaluate the results of therapy of patients with genotype 2 HCV treated during last 15 years at the Department of Infectious Diseases University Hospital Brno and Faculty of Medicine Masaryk University Brno, Czech Republic.

Patients and methods:
15 patients (9 men, 6 women, mean age 54.73 ± 13.83 years, median 54 years) with chronic genotype 2 infection were treated at in our department during last 15 years. It is the biggest group of patients with this diagnosis treated in the Czech Republic. Proportion of genotype 2 subtypes was following: 1 times subtype 2a, 2 times subtype 2a/2c, 5 times subtype 2b, in the rest 7 cases only genotype 2 was determined without possibility to determinate subtype.

Results:
9 patients were treated with the combination of peginterferon α-2a (180 µg once weekly subcutaneously) and ribavirin (1 000 or 1 200 mg daily according to the weight) for 24 weeks in the years 2002–2015, sustained virological response (SVR) achieved 6 of them (67 %). Two relapses and one breakthrough were recorded. 7 patients were treated with combination of sofosbuvir (400 mg daily) and ribavirin (1 000 or 1 200 mg daily according to the weight) for 12 weeks in the years 2015–2016 – 6 of them were treatment naïve, one after breakthrough in previous therapy. All of these 7 patients achieved SVR (100 %).

Conclusions:
Genotype 2 therapy still not represents serious therapeutic problem. The number of difficultly treatable patients is gradually increasing in many well-developed countries during last several years. However the therapeutic possibilities are quickly developing.

Key words:
chronic hepatitis C – genotype 2 – pegylated interferon – ribavirin – sofosbuvir

Zdroje

1. [European Association for the Study of Liver]. EASL recommendations on treatment of hepatitis C 2015. J Hepatol 2015; 63(1): 199–236. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2015.03.025>. Dostupné z WWW: . [30.9.2016].

2. Murphy D, Chamberland J, Dandavino R et al. A new genotype of hepatitis C virus originating from Central Africa. Hepatology 2007; 46(4 Suppl 1): S623A.

3. Tillmann HL, McHutchison JG. Hepatitis C. In: Boyer TD, Manns MP, Sanyal. A Zakim and Boyer´s Hepatology: A Textbook of Liver Disease – Expert Consult. 6th ed. Elsevier Saunders: Philadelphia 2012: 574–576. ISBN 978–1437708813.

4. [European Association for the Study of Liver]. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. J Hepatol 2014; 60(2): 392–420. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2013.11.003>.

5. [European Association for the Study of Liver]. EASL Clinical Practice Guidelines: Management of hepatitis C virus infection. J Hepatol 2011; 55(2): 245–264. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2011.02.023>.

6. Pawlotsky JM. Hepatitis C virus resistance to Direct-Acting Antiviral drugs in interferon-free regimens. Gastroenterology 2016; 151(1): 70–86. Dostupné z DOI: <http://dx.doi.org/10.1053/j.gastro.2016.04.003>.

7. [European Association for the Study of Liver]. EASL recommendations on treatment of hepatitis C 2014. J Hepatol 2014; 61(2): 373–395. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jhep.2014.05.001>.

8. [European Association for the Study of Liver]. EASL recommendations on treatment of hepatitis C 2015. J Hepatol 2015; 63(1): 199–236.

9. Kershenobich D, Muñoz L, Malé R et al. Proceed with caution peginterferon alpha-2a versus peginterferon-alpha-2b in chronic hepatitis C. A systematic review of randomized trials reply. Hepatology 2010; 52(6): 2240–2241. Author reply: Awad T et al. Hepatology 2010; 52(6): 2241–2.

10. Lawitz E, Mangia A, Wyles D et al. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med 2013; 368(20): 1878–1887. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1214853>.

11. Jacobsson IM, Gordon SC, Kowdley KV et al. Sofosbuvir for hepatitis C genotype2 and 3 patients without treatment options. N Engl J Med 2013; 368: 1867–1877. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1214854>.

12. Zeuzem S, Dusheioko GM, Salupere R et al. Sofosbuvir and ribavirin in HCV genotypes 2 and 3. N Engl J Med 2014; 370(21): 1993–2001. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1316145>.