| Resumo: |
The hepatitis C virus (HCV) causes a chronic infection that triggers a process of discrete and progressive degeneration in the liver, being an important public health problem that demands specialized health care and high complexity. Therefore, several treatments are approved with the aim of its eradication. The objective of this study was to evaluate predictors related to the therapeutic failure in the new second-generation Direct Action Agents (DAA) against HCV in a referral service in hepatology in northeastern Brazil. A retrospective real-life cohort study conducted at a referral service in hepatology, where the collection was performed from January/2018 to August/2018. Information regarding demographic data, viral load quantification, staging of liver disease and data such as prior treatment failure and therapeutic regimens were collected in the medical records. The present study was approved by the Research Ethics Committee under the number 58131716.5.000.5546. Statistical nalyses were performed using the Fisher Exact, Chi-square, Shapiro-Wilk and Mann-Whitney tests. The categorical variables were described by means of absolute and relative percentage frequencies. The continuous variables were described by means and standard deviation. Relative risks and their intervals with 95% confidence were calculated. The significance level adopted was 5% and the software used was the R Core Team 2018. There were 126 patients included in the study, of whom 21.5% had no reports in the medical records of sustained virological response results on the 12th week after treatment (SVR 12), resulting in 99 patients with SVR 12 for analysis, which generated an effectiveness rate of 91.9%, a range higher than expected when compared to clinical trials. As for the demographic characteristic of the patients, the mean age was 58 years, in addition to the predominance of males. When assessing predictors, the only predictor for an identified therapeutic failure was the presence of viral load detected at the end of treatment, relative risk 14.63 and 95% CI (4.17-51.28). However, protective factors for a therapeutic failure such as the variable genotype 1, experienced patients, were identified. The presence of the viral load detected at the end of the treatment was the only predictor of the identified therapeutic failure. DAAs were considered as successful therapy, with effectiveness above 90%. Future research on the loss of follow-up of patients being treated is important, as well as which interventions should be implemented to minimize them. |
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