TY  - JOUR
A1  - Heidrich, Benjamin
A1  - Wiegand, Steffen B.
A1  - Buggisch, Peter
A1  - Hinrichsen, Holger
A1  - Link, Ralph
A1  - Möller, Bernd
A1  - Böker, Klaus H. W.
A1  - Teuber, Gerlinde
A1  - Klinker, Hartwig
A1  - Zehnter, Elmar
A1  - Naumann, Uwe
A1  - Busch, Heiner W.
A1  - Maasoumy, Benjamin
A1  - Baum, Undine
A1  - Hardtke, Svenja
A1  - Manns, Michael P.
A1  - Wedemeyer, Heiner
A1  - Petersen, Jörg
A1  - Cornberg, Markus
T1  - Treatment of Naive Patients with Chronic Hepatitis C Genotypes 2 and 3 with Pegylated Interferon Alpha and Ribavirin in a Real World Setting: Relevance for the New Era of DAA
JF  - PLOS ONE
N2  - Evidence based clinical guidelines are implemented to treat patients efficiently that include efficacy, tolerability but also health economic considerations. This is of particular relevance to the new direct acting antiviral agents that have revolutionized treatment of chronic hepatitis C. For hepatitis C genotypes 2/3 interferon free treatment is already available with sofosbuvir plus ribavirin. However, treatment with sofosbuvir-based regimens is 10-20 times more expensive compared to pegylated interferon alfa and ribavirin (PegIFN/RBV). It has to be discussed if PegIFN/RBV is still an option for easy to treat patients. We assessed the treatment of patients with chronic hepatitis C genotypes 2/3 with PegIFN/RBV in a real world setting according to the latest German guidelines. Overall, 1006 patients were recruited into a prospective patient registry with 959 having started treatment. The intention-to-treat analysis showed poor SVR (GT2 61%, GT3 47%) while patients with adherence had excellent SVR in the per protocol analysis (GT2 96%, GT3 90%). According to guidelines, 283 patients were candidates for shorter treatment duration, namely a treatment of 16 weeks (baseline HCV-RNA <800.000 IU/mL, no cirrhosis and RVR). However, 65% of these easy to treat patients have been treated longer than recommended that resulted in higher costs but not higher SVR rates. In conclusion, treatment with PegIFN/RBV in a real world setting can be highly effective yet similar effective than PegIFN +/- sofosbuvir/RBV in well-selected naive G2/3 patients. Full adherence to guidelines could be further improved, because it would be important in the new era with DAA, especially to safe resources.
KW  - peginterferon alpha-2B
KW  - HCV genotype-2
KW  - sofosbuvir
KW  - infection
KW  - epidemology
Y1  - 2014
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-115149
SN  - 1932-6203
VL  - 9
IS  - 10
ER  - 
TY  - JOUR
A1  - Schlevogt, Bernhard
A1  - Boeker, Klaus H. W.
A1  - Mauss, Stefan
A1  - Klinker, Hartwig
A1  - Heyne, Renate
A1  - Link, Ralph
A1  - Simon, Karl-Georg
A1  - Sarrazin, Christoph
A1  - Serfert, Yvonne
A1  - Manns, Michael P.
A1  - Wedemeyer, Heiner
T1  - Weight gain after interferon-free treatment of chronic hepatitis C — results from the German Hepatitis C-Registry (DHC-R)
JF  - Biomedicines
N2  - Chronic hepatitis C can be treated very effectively with direct-acting antivirals (DAA) with only minor side effects compared to an interferon-containing treatment regimen. The significance of metabolic comorbidities after HCV cure is not well defined. This study aims to investigate short- and long-term weight change of patients receiving interferon-free antiviral treatment for chronic hepatitis C. The German Hepatitis C-registry (DHC-R) is a national multicenter real-world cohort. A total of 5111 patients were followed prospectively after DAA treatment for up to 3 years. Weight change compared to baseline was analyzed at end of treatment and at years 1, 2, and 3 after completion of antiviral therapy. Regression analysis was performed to identify baseline predictors for weight change. While there was no relevant mean weight change (−0.2 kg, SD 4.3 kg) at the end of antiviral treatment, weight started to increase during long-term follow-up reaching +1.7 kg (SD 8.0 kg, p < 0.001) compared to baseline at 3 years (follow-up year 3, FU3) after completion of antiviral therapy. 48%, 31%, and 22% of patients had a weight gain greater than 1, 3, and 5 kg at FU3, respectively. During follow-up, a body mass index (BMI) <30 proved to be the only consistent predictor for weight gain. DAA treatment is followed by a substantial weight gain (+3 kg or more) in one-third of the patients during long-term follow-up. Non-obese patients seemed to be most vulnerable to weight gain. The body compartment involved in weight gain as well as the mechanism of weight gain remain to be elucidated.
KW  - chronic hepatitis C
KW  - direct-acting antivirals
KW  - interferon-free
KW  - HCV cure
KW  - weight gain
KW  - German Hepatitis C-Registry
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-248476
SN  - 2227-9059
VL  - 9
IS  - 10
ER  -