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Coyer, Liza; Njoya, Oudou; Njouom, Richard; Mossus, Tatiana; Kowo, Mathurin Pierre; Essomba, Frida; Boers, Alexander; Coutinho, Roel; Ondoa, Pascale

Achieving a high cure rate with direct‐acting antivirals for chronic Hepatitis C virus infection in Cameroon: a multi‐clinic demonstration project

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  • Medientyp: E-Artikel
  • Titel: Achieving a high cure rate with direct‐acting antivirals for chronic Hepatitis C virus infection in Cameroon: a multi‐clinic demonstration project
  • Beteiligte: Coyer, Liza; Njoya, Oudou; Njouom, Richard; Mossus, Tatiana; Kowo, Mathurin Pierre; Essomba, Frida; Boers, Alexander; Coutinho, Roel; Ondoa, Pascale
  • Erschienen: Wiley, 2020
  • Erschienen in: Tropical Medicine & International Health
  • Sprache: Englisch
  • DOI: 10.1111/tmi.13450
  • ISSN: 1360-2276; 1365-3156
  • Schlagwörter: Infectious Diseases ; Public Health, Environmental and Occupational Health ; Parasitology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>Highly effective direct‐acting antivirals (DAAs) for Hepatitis C treatment are largely inaccessible in sub‐Saharan Africa. Data on treatment feasibility and outcomes in clinical settings are limited. We assessed the feasibility of achieving a high (≥90%) cure rate with DAAs in six gastroenterology clinics in Cameroon.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Patients with chronic Hepatitis C virus (HCV) infection were treated for 12 or 24 weeks with ledipasvir/sofosbuvir, ledipasvir/sofosbuvir/ribavirin or sofosbuvir/ribavirin, depending on the stage of liver disease and HCV genotype. The cure rate was defined as the proportion of patients with a sustained virological response 12 weeks after treatment completion (SVR12) among all treatment completers.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We identified 190 HCV RNA positive patients between September‐2017 and August‐2018, 161 (84.7%) of whom started treatment. 105 (65.2%) were female, median age was 61.3 years [IQR = 55.9–66.9] and 11 (6.8%) were HIV‐positive. Median plasma HCV RNA was 6.0 log<jats:sub>10 </jats:sub>IU/mL [IQR = 5.6–6.4]. HCV genotypes identified were 1 (34.8%), 2 (13.7%), 4 (50.9%), 1 and 4 (0.6%); 46 (28.6%) strains of 160 single‐genotype infections were non‐subtypeable. Of 158 treatment completers, 152 (96.2%, 95%CI = 91.9–98.6%) achieved SVR12. Six patients did not achieve SVR12: five carried HCV with NS5A resistance mutations and one with NS5B resistance mutations. Three patients died before and two after treatment completion. The most common adverse events were asthenia (12.0%), headache (11.4%) and dizziness (18.9%).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>High cure rates of Hepatitis C with DAAs are achievable in clinical settings of Cameroon. However, the accessibility and provision of HCV screening, diagnosis, treatment, monitoring and care should be addressed for large‐scale implementation.</jats:p></jats:sec>
  • Zugangsstatus: Freier Zugang