Le suivi de l’efficacité et de la tolérance des antiviraux à action directe dans le traitement de l’hépatite virale C chronique à l’Hôpital national Donka CHU Conakry
Abstract
Introduction : L’hépatite virale C est un véritable problème de santé publique dans le monde. Patients et Méthodes : Il s’agissait d’une étude analytique prospective portant sur tous les patients suivis dans le service durant la période d’étude. Elle a été menée du 1er Janvier 2022 au 30 Mars 2024 soit 27 mois en consultation externe du service d’Hépato-Gastroenterologie de l’hôpital national Donka CHU Conakry. Le but de notre travail était d’évaluer la tolérance et l’efficacité des antiviraux à action directe chez les patients porteurs du VHC virémiques. Résultats : Les résultats concernaient 83 patients, 46 étaient des hommes (55,7%) et 37 des femmes (44,3%), avec un sex ratio H/F de 1,24. L’âge moyen des patients était de 46 ans avec des extrêmes de 22 à 80 ans. La tranche d’âge de 30-50 ans était la plus touchée par l’hépatite virale C avec une fréquence de 56%. Les protocoles thérapeutiques utilisés étaient le Sofosbuvir-Velpatasvir (95,18%), le Sofosbuvir-Velpatasvir-Ribavirine (4,82%). La réponse virale soutenue a été de 100% chez les patients terminé leur traitement. Des effets secondaires indésirables ont été observés chez 40 de nos patients soit une fréquence de 48,19%. Les principaux effets indésirables étaient des céphalées (36,14%), des nausées et vomissements (32,53%), un prurit (12,04%), des crampes musculaires (10,84%). Conclusion : Le traitement de l’hépatite virale C repose sur les antiviraux à action directe qui sont efficaces et bien tolérés permettant d’obtenir une réponse virale soutenue à 100%. Chez les patients guéris avec une fibrose hépatique F3-F4 la surveillance doit être maintenue.
Introduction: Viral hepatitis C is a real public health problem worldwide. Patients and Methods: This was a prospective analytical study involving all patients followed in the department during the study period. It was conducted from January 1, 2022, to March 30, 2024, i.e. 27 months in the outpatient clinic of the Hepato-Gastroenterology department of the Donka CHU Conakry National Hospital. The aim of our work was to evaluate the tolerance and efficacy of direct-acting antivirals in patients with viremic HCV. Results: The results concerned 83 patients, 46 were men (55.7%) and 37 women (44.3%), with a sex ratio M/F of 1.24. The mean age of the patients was 46 years with extremes of 22 to 80 years. The age group of 30-50 years was the most affected by viral hepatitis C with a frequency of 56%. The therapeutic protocols used were Sofosbuvir-Velpatasvir (95.18%), and Sofosbuvir-Velpatasvir-Ribavirin (4.82%). The sustained viral response was 100% in patients who completed their treatment. Adverse side effects were observed in 40 of our patients, i.e. a frequency of 48.19%. The main adverse effects were headache (36.14%), nausea and vomiting (32.53%), pruritus (12.04%), and muscle cramps (10.84%). Conclusion: Treatment of viral hepatitis C is based on direct-acting antivirals that are effective and well tolerated, allowing a sustained viral response of 100%. In cured patients with F3-F4 liver fibrosis, monitoring should be maintained.
Downloads
Metrics
PlumX Statistics
References
2. Anonymous. Global surveillance and control of hepatitis C; Report of a WHO consultation organized in collaboration with the Viral Hepatitis Prevention Board. J Viral Hepatitis 1999 ; 6 : 35-47.
3. Bang CS, Song IH. Impact of antiviral therapy on hepatocellular carcinoma and mortality in patients with chronic hepatitis C: systematic review and meta-analysis. BMC Gastroenterol. 2017 apr 4; 17 (1): 46.
4. Buffet C. Marqueurs biologiques sériques et dépistage des hépatites virales. Rev Prat 1995 ; 45 : 168-73.
5. Cheinquer H, Sette H Jr, Wolff FH, De Araujo A, Coelho6borges S, Soares SRP, et al. Treatment of chronic HCV infection with the new direct acting antiviral (DAA): first report of real-world experience in southern Brazil. Ann Hepatol. 2017; 16 (5): 727-33.
6. De Pace V, Morelli MC, Ravaioli M, Galli S, Vero V, et al. Efficacy, Safety, and Predictors of Direct-acting antivirals in Hepatitis C Virus Patients with Heterogeneous Liver Diseases. New Microbiol. 2019 Oct;42(4):189-196. Epub 2019 Oct 14. PMID: 31609453
7. Diallo M Sarifou, Youssouf Oumarou, Diallo A Tidiane, et al. Risk Factors for Hepatic Fibrosis in Patients with Chronic Viral Hepatitis B at the Hospital National Donka CHU in Conakry. Gastroint Hepatol Dig Dis. 2024; 7(2): 1-6. doi 10.33425/2639-9334.1080
8. Diallo Mamadou Sarifou, Youssouf Oumarou, Wann Thierno Amadou, et al. Epidemiological Clinical Aspects, Risk Factors and Paraclinical and Therapeutics of Chronic Viral C Hepatitis at the Donka Natioanl Hospital CHU Conakry. Gastroint Hepatol Dig Dis 2024; 7(3): 1-7. doi 10. 33425/2639-9334.1083
9. Diallo MS, TA Wann, D Diallo, K Diallo, MLY Bah, SM Sylla, et al. Autoimmune hepatitis complicated by cirrhosis: about an observation at the Conakry University Hospital. Jaccr Africa, 2023 : 7 (3) : 65-70.
10. Diallo MS, Youssouf O, Yaogo A, Diallo D, Diallo K, Wann TA, Diallo AT, Bah MLY, Diakhaby Mamadou, Kanté MA. And Sylla Djibril (2024). Evaluation of Hepatic Fibrosis and Hepatic Steatosis by Pulse Elastography (FIBROSCAN) in Asymptomatic Patients about 170 Cases at the Donka CHU National Hospital in Conakry. Open Journal of Gastroenterology, 14 ; 125-138. doi:10.4236/ojgas.2024.144014
11. European Association for the Study of the Liver. EASL Recommandations on Treatment of Hepatitis C 2016. J Hepatol 2016. http//dx doi.org/101016/j.
12. European Association for the Study of the Liver. EASL Recommendations on treatment of Hepatitis C 2018. J Hepatol. 2018; 69: 461-511.
13. Ghany MG, Morgan TR; ASSLD-IDSA. Hepatitis C Guidance Panel. Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases-Infections Diseases Society of America Recommendations for Testing Management, and Treating Hepatitis C Virus Infection. Hepatology. 2020 Feb; 71(2): 686-721. doi 10. 1002/ hep.31060. PMID: 31816111.
14. Graham R Foster , Nezam Afdhal, Stuart K Roberts, Norbert Bräu, Edward J Gane, Stephen Pianko, Eric Lawitz, Alex Thompson, Mitchell L Shiffman, Curtis Cooper, William J Towner, Brian Conway, Peter Ruane, Marc Bourlière, Tarik Asselah, Thomas Berg, Stefan Zeuzem, William Rosenberg, Kosh Agarwal, Catherine A M Stedman, Hongmei Mo, Hadas Dvory-Sobol, Lingling Han, Jing Wang, John McNally, Anu Osinusi, Diana M Brainard, John G McHutchison, Francesco Mazzotta, Tram T Tran, Stuart C Gordon, Keyur Patel, Nancy Reau, Alessandra Mangia, Mark Sulkowski; ASTRAL-2 Investigators; ASTRAL-3 Investigators N Engl J Med. 2015 Dec 31;373(27):2608-17. doi: 10.1056/NEJMoa1512612.
15. Jordan J Feld , Ira M Jacobson, Christophe Hézode, Tarik Asselah, Peter J Ruane, Norbert Gruener, Armand Abergel, Alessandra Mangia, Ching-Lung Lai, Henry L Y Chan, Francesco Mazzotta, Christophe Moreno, Eric Yoshida, Stephen D Shafran, William J Towner, Tram T Tran, John McNally, Anu Osinusi, Evguenia Svarovskaia, Yanni Zhu, Diana M Brainard, John G Mc Hutchison, Kosh Agarwal, Stefan Zeuzem; ASTRAL-1 Investigators N Engl J Med. 2015 Dec 31;373(27):2599-607. doi: 10.1056/NEJMoa1512610.
16. Kodjoh N. Fighting viral hepatitis B and C in Africa Focus on Benin. Médecine Santé Trop. Avr 2015 ; 25 (2) : 131-4.
17. Kpoussou AR, Séhonou J, Wanvoegbe FA, Abattan C, Sokpon CNM, Vignon RK. Hépatite virale B et C : aspects épidémiologiques et cliniques au Centre National hospitalier et Universitaire de Cotonou. Médecine d’Afrique Noire, 2019, vol 66, NO 1 : 6-12.
18. Ly KN, Xing J, Klevens RM, et al. The increasing burden of mortality from viral hepatitis in the United States between 1999 and 2007. Ann Intern Med. 2012 ; 156 : 271-8.
19. Miailhes P, Trepo C. L’histoire naturelle de l’infection par le virus de l’hépatite C. Med Mal Inft 2000 ; 30 (suppl1) : 8-13.
20. Nezam Afdhal , Stefan Zeuzem, Paul Kwo, Mario Chojkier, Norman Gitlin, Massimo Puoti, Manuel Romero-Gomez, Jean-Pierre Zarski, Kosh Agarwal, Peter Buggisch, Graham R Foster, Norbert Bräu, Maria Buti, Ira M Jacobson, G Mani Subramanian, Xiao Ding, Hongmei Mo, Jenny C Yang, Phillip S Pang, William T Symonds, John G McHutchison, Andrew J Muir, Alessandra Mangia, Patrick Marcellin; ION-1 Investigators N Engl J Med. 2014 May 15;370(20):1889-98. doi: 10.1056/NEJMoa1402454. Epub 2014 Apr 11.
21. Sombie R, Bougouma A, Somda S, Sangare L, Lompo O, Kabore Z, Tieno H, Drabo J, Ilboudo D. Hépatite virale C chronique : épidémiologie, diagnostic et traitement au CHU Yalgado -Ouédraogo de Ouagadougou. J. Afr. Hépatol Gastroentérol. 2011 ; 5 : 6-13.
22. Ying Yang, Feng-Ping Wu, Wen-Jun Wang, Juan-Juan Shi, Ya-Ping Li, Xin Zhang, and Shuang-Suo Dang. Real life efficacy and safety of direct-acting antiviral therapy for treatment of patients infected with hepatitis C virus genotypes 1, 2 and 3 in northwest China. World J Gastroenterol. 2019 Nov 28; 25(44): 6551–6560. Published online 2019 Nov 28. doi: 10.3748/wjg. v25.i44.6551
Copyright (c) 2024 Diallo Mamadou Sarifou, Youssouf Oumarou, Diallo Mamadou Oury Safiatou, Diallo Kadiatou, Diallo Djenabou, Diallo Ahmed Tidiane, Wann Thierno Amadou, Bah Mamadou Lamine Yaya, Sylla Djibril
This work is licensed under a Creative Commons Attribution 4.0 International License.
