Analysis of Clinical Study: Effective Treatment of HCV Patients
It has been reported that hepatitis C virus (HCV) infection is associated with cryoglobulinemia and B-cell lymphoproliferative disorders. Additionally, epidemiological studies stated that there is higher prevalence of HCV among patients with B-NHLs than general populations. Although interferon (IFN)-based antiviral therapy has been known as an effective treatment in clearing HCV infection, it has been reported that it could lead to regression of different lymphomas. Different direct acting antiviral drugs (DAA) have been recently approved for HCV treatment associated with B-cell lymphoproliferative disorders. DAAs therapies can result in viral infection clearance in about 90% of the patients except for patients who suffer from particular diseases such as cirrhosis, and it has been also reported that those therapies are more safe than IFN treatments. In this study, the researchers evaluated the efficiency of DAAs treatment, and evaluated the virological and lyphoproliferative response (LDR) among patients with lymphoproliferative disorders.
The study lasted for twelve weeks, and included total 46 patients: 43 patients with B-cell non-Hodgkin lymphomas (NHLs), 3 patients with chronic lymphocytic leukemia (CLL), and all patients had HCV infection. Furthermore, 37 patients had marginal zone lymphomas (MZLs), 2 lymphoplasmacytic lymphomas, 2 follicular lymphomas, 4 CLL/small lymphocytic lymphomas, and 1 low-grade NHL. 39 patients received a sofosbuvir-based DAA, and 7 patients who had cirrhosis received other DAAs treatments. Negligible level of toxicity was observed as only 13 patients developed grade 1 to 2, and one patient showed grade 3 event such as asthenia.
The results of the study showed that 45 patients showed significant virological response (98%), 67% was the LDR rate, and 12 patients (26%) had complete response. Only one patient suffering from cirrhosis did not show virological response, and underwent progression of lymphoma and early death. The researchers conducted follow-up studies after 8 months, and the results of the study showed a 75% survival rate at the end of DAAs therapy. It was also emphasized that DAAs led to significant reduction of HCV associated with lymphoma regression.
This study gave a strong evidence that Direct-acting antiviral therapies could be very effective to treat HCV patients with different types of lymphomas especially those of marginal zone lymphomas. The researchers suggest that those DAAs therapies should be the first line therapy for patients with progression history of HCV with B-NHL because of the therapy’s safety, efficiency, and high virological response.
