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      Efficacy of DAAs in the Treatment of Chronic HCV: Real-World Data from the Private Health-Care Sector of the Kingdom of Saudi Arabia

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          Abstract

          Background and Aim: The hepatitis C virus (HCV) is considered a global health challenge that requires urgent interventions for prevention and control. In this study, we aimed to evaluate the effectiveness of direct-acting antiviral agents (DAAs) for HCV-infected patients in the Kingdom of Saudi Arabia (KSA).

          Patients and Methods: In this retrospective cohort study, we ascertained data of patients treated with DAA-based regimens for chronic HCV in the private health-care sector hospitals of KSA between April 2015 and December 2017. Data regarding presence or absence of liver cirrhosis, virus genotype, quantitative HCV RNA test, fibrosis stage, and history of liver disease were included. The primary end point of the study was the overall cure rate, defined as the number of patients achieving sustained viral response (SVR) rate at least 12 weeks following completion of treatment, divided by the total number of patients included in the study.

          Results: A total of 262 patients fulfilled the study inclusion criteria. Adult patients were enrolled, of which 114 (44%) were females and 148 (56%) were males. About 105 of the patients (40%) were cirrhotic and 156 were treatment-naïve patients (60%), 84 patients were interferon (INF) experienced, and 22 patients had previously received new DAAs but failed to achieve SVR. The majority of patients received ledipasvir–sofosbuvir±RBV (57%) with SVR rate of approximately 97%.

          Conclusions: Our local real-world data indicate an overall HCV cure rate of 97% following treatment with DDA#x2019;s when prescribed in the private sector. This estimate is acquiescence with previously reported global cure rates.

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          Introduction: a smouldering public-health crisis.

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            Hepatitis C treatment: where are we now?

            Chronic hepatitis C infection affects millions of people worldwide and confers significant morbidity and mortality. Effective treatment is needed to prevent disease progression and associated complications. Previous treatment options were limited to interferon and ribavirin (RBV) regimens, which gave low cure rates and were associated with unpleasant side effects. The era of direct-acting antiviral (DAA) therapies began with the development of first-generation NS3/4A protease inhibitors in 2011. They vastly improved outcomes for patients, particularly those with genotype 1 infection, the most prevalent genotype globally. Since then, a multitude of DAAs have been licensed for use, and outcomes for patients have improved further, with fewer side effects and cure rates approaching 100%. Recent regimens are interferon-free, and in many cases, RBV-free, and involve a combination of DAA agents. This review summarizes the treatment options currently available and discusses potential barriers that may delay the global eradication of hepatitis C.
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              Epidemiology of hepatitis C virus in the Arabian Gulf countries: Systematic review and meta-analysis of prevalence.

              The aims of this study were to perform a systematic review and synthesize epidemiological data on hepatitis C virus (HCV) in the Arabian Gulf countries, and to assess the country-specific prevalence among nationals and expatriate populations.
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                Author and article information

                Journal
                J Epidemiol Glob Health
                J Epidemiol Glob Health
                JEGH
                Journal of Epidemiology and Global Health
                Atlantis Press
                2210-6006
                2210-6014
                June 2020
                : 10
                : 2
                : 178-183
                Affiliations
                [1 ]Department of Medicine, The University of Jeddah, Jeddah, Saudi Arabia
                [2 ]Pharmaceutical Care and Management Unit, Bupa Arabia, Jeddah, Saudi Arabia
                [3 ]Department of Medicine, Almana General Hospital, Alkhobar, Saudi Arabia
                [4 ]Clinical Governance, Bupa Arabia, Jeddah, Saudi Arabia
                [5 ]Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
                Author notes
                [* ]Corresponding author. Email: mmosli@ 123456kau.edu.sa
                Article
                JEGH-10-2-178
                10.2991/jegh.k.200117.002
                7310777
                32538035
                97e346b6-9da8-42ed-9fe4-782bef7a5590
                © 2020 Atlantis Press International B.V.

                This is an open access article distributed under the CC BY-NC 4.0 license ( http://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 10 August 2019
                : 05 January 2020
                Categories
                Research Article
                Research Article

                hepatitis c virus,treatment,anti-viral,agents,direct acting,real world,saudi arabia

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