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Acta Médica Costarricense
versión On-line ISSN 0001-6002versión impresa ISSN 0001-6012
Resumen
RAMIREZ-QUESADA, Wagner Enrique; MADRIGAL-BORLOZ, Marianella; BARAHONA-GARCIA, Ricardo y HEVIA-URRUTIA, Francisco. Sustained virological response in patients with chronic hepatitis C treated with direct acting antivirals, a retrospective study from Costa Rica. Acta méd. costarric [online]. 2020, vol.62, n.4, pp.187-195. ISSN 0001-6002.
Introduction:
Costa Rica has a public healthcare system that made possible the detection of hepatitis C (HCV) infected patients and offer them treatment with last-generation direct-acting antivirals (DAA). Nonetheless, there has not been any published studies that evaluate the response of the Costa Rican population to these drugs.
Aim:
To describe the clinical effectiveness of direct acting antiviral treatment in a cohort treated in the Social Security Care from Costa Rica (CCSS).
Materials and Methods:
Retrospective review of clinical records of all patients who were treated with: sofosbuvir/ledipasvir, sofosbuvir/velpatasvir and ombitasvir/paritaprevir/ritonavir/dasabuvir in three national adult hospitals from between 2017-2018. Epidemiological, clinical and laboratory data were collected, and pre- and post- treatment results were compared.
Results:
139 patients were recruited, 22 were excluded because they did not fulfill the inclusión criteria. The analysis was made with 117 patients; from which 101 had their viremia documented in their records for the determination of sustained virological response (SVR). The majority of patients were Costa Ricans born between 1945-1965, whose risk factors for hepatitis C were not documented, with a non-cirrhotic, genotype 1b infection. Overall SVR was 98%. There was not a significant difference of response between cirrhotic (94%) and non-cirrhotic population (100%).
There was a significant reduction (p< 0,01) in:
Aspartate Aminotranferase to Platelet Ratio Index (APRI), the score of the Model for End-Stage Liver Disease (MELD), Alanine Aminotransferase (ALT) and total bilirubin in patients treated with DAA.
Conclusion:
The direct acting antivirals were effective in population treated in our country, with SVR similar to those reported in real life studies from other regions of the world.
Palabras clave : hepatitis C; antivirales; Costa Rica; sustained viral virologic response.