Antivirals
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Hepatotoxicity and virologic failure: 9 case reports In a real-world, multicentre, retrospective, uncontrolled, non-randomised, national study of 862 patients (aged >18 years) with hepatitis C virus (HCV) infection treated with combination therapy in Turkey between 1 April 2017 and 31 August 2018, 9 patients including 4 men and 3 women aged 42–66 years [ages and sexes of 2 patients not stated] were described, who developed hepatotoxicity or exhibited virologic failure following treatment with dasabuvir, ombitasvir/paritaprevir/ritonavir, ribavirin or unspecified antiviral therapy for HCV infection [routes, times to reactions onsets and outcomes of ADR not stated; not all dosages stated]. All the patients had chronic HCV infection, with genotype 1a (n=2), genotype 1b (n=4) and genotype 4 (n=1), while genotype was not stated for 2 patients. Three patients had concurrent compensated cirrhosis. They were scheduled to receive secondgeneration direct-acting antiviral therapy with dasabuvir, ombitasvir/paritaprevir/ritonavir or ribavirin. The 2 patients, who had HCV genotype 1a infection, started receiving ombitasvir/paritaprevir/ritonavir [Viekirax] two tablets once daily, dasabuvir [Exviera] 250mg two tablets per day and ribavirin, and therapy was scheduled for 12 weeks (n=1; non-cirrhotic patient) and for 24 weeks (n=1; compensated cirrhotic patient). The 4 patients, who had HCV genotype 1b infection, started receiving ombitasvir/ paritaprevir/ritonavir [Viekirax] two tablets once daily and dasabuvir [Exviera] 250mg two tablets per day, and therapy was scheduled for 12 weeks. One patient, who had HCV genotype 4 infection, started receiving ombitasvir/paritaprevir/ritonavir [Viekirax] two tablets once daily and ribavirin, and therapy was scheduled for 12 weeks. Two patients (with unspecified genotype) started receiving ombitasvir/paritaprevir/ritonavir [Viekirax] two tablets once daily and unspecified antiviral therapy. Seven of these patients (with known genotype) completed the scheduled therapy. However, they exhibited virologic failure in the form of virologic relapse (n=3) and non-response (n=4) following treatment with dasabuvir, ombitasvir/paritaprevir/ritonavir or ribavirin for HCV infection. Three patients, who exhibited virologic relapse, had undetectable HCV RNA at the end of treatment; however, HCV RNA was found to be positive within 12 weeks post-treatment (follow-up). Four patients, who exhibited non-response, had detectable HCV RNA at the end of treatment. The 2 patients (with unspecified genotype) developed hepatotoxicity secondary to ombitasvir/ paritaprevir/ritonavir and unspecified antiviral therapy, with elevated ALT and AST levels. The hepatotoxicity was complicated by jaundice in both the patients. Therefore, in both the patients with hepatotoxicity, the antiviral therapy was discontinued after 14 days. Aygen B, et al. Real-world efficacy, safety, and clinical outcomes of ombitasvir/paritaprevir/ritonavir +/- dasabuvir +/- ribavirin combination therapy in patients with hepatitis C virus genotyp
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