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Anales del Sistema Sanitario de Navarra

Print version ISSN 1137-6627


JUANBELTZ, R. et al. Effectiveness of second-generation direct-acting antivirals in chronic hepatitis C. Anales Sis San Navarra [online]. 2017, vol.40, n.1, pp.57-66. ISSN 1137-6627.


Second-generation direct-acting antivirals (DAA) have shown high sustained virologic response (SVR) for the treatment of chronic hepatitis C in clinical trials. The objective of this study is to estimate DAA effectiveness in treatment of this disease.


Hepatitis C virus (HCV) monoinfected patients and HCV-human immunodeficiency virus (HIV) coinfected patients who started interferon-free DAA based regimens during 2015 were included. The primary effectiveness outcome was SVR, defined as an undetectable viral load 12 weeks after the end of treatment.


A total of 293 patients were enrolled, and 52 (17.7%) were HIV coinfected. HCV 1b genotype was the most prevalent in monoinfected patients (41.5%) and 1a in HIV coinfected patients (40.4%). The proportion of cirrhosis was higher among HIV coinfected patients (69.2% vs 41.1%; p<0.0001), mostly Child-Pugh A. SVR was achieved by 96.9% of patients (284/293), in an intention-to-treat analysis (CI 95%: 94.9-98.9), in which just 4 people had virologic failure. Both naïve and pretreated patients had SVR higher than 95%, and in most of subgroups, according to the presence of cirrhosis, HIV coinfection and HVC genotype, effectiveness rates were near or above 90%.


DAA are highly effective, with similar or higher rates of SVR than that found in clinical trials, and even among difficult to treat populations.

Keywords : Chronic hepatitis C; HIV; Antiviral agents; Treatment outcome; Clinical practice pattern.

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