Real‐life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study

Background and aims It is paramount to identify predictors of treatment failure with direct antiviral agents in ‘field‐practice’ patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field‐practice scenario are scant. The multicentre MIST...

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Bibliographic Details
Published in:Liver international 2019-10, Vol.39 (10), p.1852-1859
Main Authors: Persico, Marcello, Aglitti, Andrea, Milella, Michele, Coppola, Carmine, Messina, Vincenzo, Claar, Ernesto, Gentile, Ivan, Sogari, Fernando, Pierri, Paola, Surace, Lorenzo A., Morisco, Filomena, Tundo, Paolo, Brancaccio, Giuseppina, Serviddio, Gaetano, Gatti, Pietro, Termite, Antonio P., Di Costanzo, Giovan G., Caroleo, Benedetto, Cozzolongo, Raffaele, Coppola, Nicola, Longo, Annamaria, Fontanella, Luca, Federico, Alessandro, Rosato, Valerio, Terrenato, Irene, Masarone, Mario
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antiviral agents
Antiviral Agents - therapeutic use
Benzimidazoles - therapeutic use
cirrhosis
Correlation analysis
Creatinine
direct‐acting antiviral
Drug abuse
Drug Therapy, Combination
Effectiveness
efficacy
Epidemics
Female
Fibrosis
Genotype
Genotypes
HCV genotype
Hepacivirus - drug effects
Hepacivirus - genetics
Hepatitis
Hepatitis C
Hepatitis C, Chronic - drug therapy
Humans
Italy
Kidney diseases
Liver Cirrhosis - virology
Longitudinal Studies
Male
Medical treatment
Middle Aged
Patients
Prospective Studies
Quinoxalines - therapeutic use
Subgroups
substance abuse
Substance Abuse, Intravenous - complications
Substance use
Sulfonamides - therapeutic use
Sustained Virologic Response
Viruses
Young Adult
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Summary:Background and aims It is paramount to identify predictors of treatment failure with direct antiviral agents in ‘field‐practice’ patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field‐practice scenario are scant. The multicentre MISTRAL study enrolled 1177 patients, including PWID, to assess real‐life efficacy and safety of GLE/PIB and to identify the predictive factors for this treatment. Methods This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12. Results A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3. METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID. Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non‐substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ2 
ISSN:1478-3223
1478-3231
DOI:10.1111/liv.14170