Treatment of Chronic Hepatitis C: An Experience Report from a Referral Center in Northeastern Brazil

Background: Therapy for the hepatitis C virus (HCV) has undergone a revolution with the introduction of direct-acting antivirals (DAA). DAAs achieve sustained virological response (SVR) in 90-95% of treated patients, compared to 50-70% of those receiving dual pegylated interferon and ribavirin therapy. Although they are already available, there are few studies on DAAs efficacy in the Brazilian population. Objective: To evaluate the efficacy of DAAs in individuals with hepatitis C at the Liver Study Center (LSC) in Hospital Universitário Onofre Lopes (HUOL). Methods: Medical records of chronic HCV patients treated with DAAs from LSC were analyzed. Only those patients with a follow-up of at least 12 weeks after the end of treatment were included. Results: A total of 50 patients underwent treatment with DAAs at LSC. Of these, genotype 1 was present in 39 patients (81.2%, 1a8.3%, 1b68.7%), genotype 2, in 2 patients (4.2%) and genotype 3, in 6 patients (14.5%, 3a 2%). Thirty-two were cirrhotic (64%), and 20 were treatment-experienced (40%). The therapeutic regimens used were mainly sofosbuvir (SOF) + simeprevir (SMV) in 23 patients (46%) and SOF + daclatasvir (DCV), in 22 (44%). SVR-12 was achieved in 92% of patients. Four patients had virological failure: three of them were cirrhotic and treatment experienced. The other one had advanced liver fibrosis (F3) with no previous treatment for HCV infection. No adverse events were reported during DAA treatment. Conclusion: The experience of the LSC with DAAs showed a high rate of SVR and excellent tolerability