Yusoff, Ahmad Syahidan
(2019)
Assessment of the efficacy of hepatitis C treatment in Hospital Universiti Sains Malaysia (HUSM).
Masters thesis, Universiti Sains Malaysia.
Abstract
Background : Management of Hepatitis C virus (HCV) infection has been evolved in the
last few years. Currently, the newer treatment direct acting antivirals (DAAs) promise a
higher rate of efficacy to compare to previous treatment, pegylated interferon. The goal
of HCV treatment is to eradicate the virus and to avoid the progression of liver fibrosis
and HCV-related disease. Sustained virologic response (SVR) is the most widely used
efficacy endpoint in clinical studies of hepatitis C and represents the eradication of HCV
from the body. We conduct a study to compare the efficacy of Hepatitis C treatment
between pegylated interferon and DAA, it effects towards liver function and its
associated factors in our cohort of patient therefore, support our continuing use of DAA
in the treatment of Hepatitis C virus infection in HUSM.
Methodology: This is a retrospective record review done by reviewing a record of 88
patients who were either on Pegylated Interferon or on DAAs during the period of 2011 till
2018. Subjects were who achieved undetectable viral load in serum after 12 or 24 weeks
after completed therapy was taken as a sustained virological response (SVR). We also
evaluated the variation of ALT at baseline and 12 weeks after completed therapy. All
relevant data are gathered and recorded in statistical software for analysis.
Result: Between January 2011 and September 2018, 35 patients started a DAA treatment
and 53 patients had completed pegylated interferon treatment. Overall proportion of
SVR12 was 92% (n=32) for DAAs and 69.8%(n=37) for interferon-based treatment.
Analysis of ALT showed that the level normalized in the most patients who had achieved
SVR (68%). Factors such as gender, genotype, race, pre-treatment HCV RNA level and
liver cirrhosis are shown not to be associated with the efficacy of treatment.
Conclusion : Achievement of the high rate of SVR represents the goal for HCV treatment
and has implications to reduce risk of liver disease progression and extrahepatic disease.
However, further studies are needed to include more patients in order to improve power of
the study. Based on the higher rate of SVR associated with DAA therapy, this should be
the first choice of treatment.
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