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Læknablaðið - 01.03.2017, Síða 20

Læknablaðið - 01.03.2017, Síða 20
128 LÆKNAblaðið 2017/103 R A N N S Ó K N ENGLISH SUMMARY Background/Aims: Hepatitis C is a major cause of chronic liver disease and cirrhosis in Western countries. Its treatment aims at eradicating the virus and patients are considered cured if the virus is undetectable by PCR in blood 12-24 weeks after end of treatment (sustained virological response, SVR). The aim of this study is to investigate the results of treating hepatitis C in Iceland during the period 2002-2012. Materials and methods: Retrospective study including all patients with hepatitis C receiving treatment with peginterferone and ribavirin at Landspitali University hospital during the period 2002-2012. Pati- ents who had been treated previously were excluded. Information was obtained from medical records and the hospital pharmacy. Results: A total of 207 patients were included, 136 (66%) males and 71 (34%) females. Mean age was 38 years (range 17-66). Genotyping revealed that 71 (34%) patients had genotype 1, 135 (65%) genotype 3 and one genotype 2. A total of 147 (71%) patients achieved SVR. The rate of SVR was 77.8% for genotype 3 and 57.7% for genotype 1. 9 patients (4%) had cirrhosis and 3 of them had SVR. Of 161 patients who finished treatment per protocol, 87.5% and 77.1% with genotypes 3 and 1 respectively had SVR. Conclusions: The study demonstrates higher rates of SVR in clinical practice in Iceland compared to controlled clinical trials. The improved effectiveness may be explained by younger patient population, low rate of cirrhosis and close follow-up of patients. Treatment of hepatitis C with peginterferon and ribavirin in Iceland from 2002-2012 Benedikt Friðriksson1, Óttar Már Bergmann2, Sigurður Ólafsson2 1Department of Medicine, 2Division of Gastroenterology and Hepatology, Landspítali - The National University Hospital of Iceland, Reykjavík. Key words: Hepatitis C, peg-interferon, sustained virological response. Correspondence: Sigurður Ólafsson, sigurdol@landspitali.is Heimildir 1. Lavanchy D. The global burden of hepatitis C. Liver Int 2009; 29 Suppl 1: 74-81. 2. Gonzalez HC, Duarte-Rojo A. Virologic Cure of Hepatitis C: Impact on Hepatic Fibrosis and Patient Outcomes. Curr Gastroenterol Rep 2016; 18: 32. 3. Ara AK, Paul JP. New Direct-Acting Antiviral Therapies for Treatment of Chronic Hepatitis C Virus Infection. Gastroenterol Hepatol (N Y) 2015; 11: 458-66. 4. Afdhal N, Zeuzem S, Kwo P, Chojkier M, Gitlin N, Puoti M, et al. Ledipasvir and sofosbuvir for untreated HCV genotype 1 infection. N Engl J Med 2014; 370: 1889-98. 5. Lawitz E, Gane EJ. Sofosbuvir for previously untreated chronic hepatitis C infection. N Engl J Med 2013; 369: 678- 9. 6. Lawitz E, Sulkowski MS, Ghalib R, Rodriguez-Torres M, Younossi ZM, Corregidor A, et al. 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Ghany MG, Strader DB, Thomas DL, Seeff LB, Diseases AAftSoL. Diagnosis, management, and treatment of hepa- titis C: an update. Hepatology 2009; 49: 1335-74. 21. Marcellin P, Cheinquer H, Curescu M, Dusheiko GM, Ferenci P, Horban A, et al. High sustained virologic response rates in rapid virologic response patients in the large real-world PROPHESYS cohort confirm results from randomized clinical trials. Hepatology 2012; 56: 2039-50. 22. Innes HA, Hutchinson SJ, Allen S, Bhattacharyya D, Bramley P, Carman B, et al. Ranking predictors of a sustained viral response for patients with chronic hepa- titis C treated with pegylated interferon and ribavirin in Scotland. Eur J Gastroenterol Hepatol 2012; 24: 646-55. 23. SÁÁ. Ársrit SÁÁ 2007-2010. SÁÁ: Samtök áhugafólks um áfengis- og vímuefnavandann, Reykjavík 2010. 24. Abergel A, Hezode C, Leroy V, Barange K, Bronowicki JP, Tran A, et al. 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