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Master Thesis

Traitement de l'hépatite C en 2011-2013 : les résultats dans la "vraie vie" à l'heure de la trithérapie

Abstract : Introduction: The treatment of chronic hepatitis C patients with genotype 1 has evolved in 2011 with the arrival of the first generation of protease inhibitors, boceprevir and telaprevir. Objectives: a) assess the proportion of patients treated for hepatitis C at Brest CHU between 2011 and 2013, b) compare the efficacy of treatment in "real life" and results in the literature, and c) evaluate the safety of triple therapy. Results: Treatment was performed in 47.5% of patients (84/177). F3/F4 fibrosis was observed in 50% of cases. Strict consensus recommendations (treatment for fibrosis ≥ 2 and waiting when minimal fibrosis) were more often applied in cases of genotype 1 (83.3% vs 65.2% in cases of genotype non-1). Sustained virologic response rates were 58.3% in genotype 1 patients and 82.6% in genotype non-1 patients. Treatment discontinuations were more frequent in genotype 1 patients (33.3% vs. 17.4% in case of genotype non-1), 22% inefficiency in genotype 1 patients. Conclusion: These results were satisfactory in view of the complexity of the situations (comorbidities, severe fibrosis, no response to previous treatment, patients in therapeutic impasse). Our results suggest that a peginterferon plus ribavirin lead-in-phase should be applied in all patients who have failed previous treatment, even when treatment with telaprevir is considered. Nevertheless, there are still many patients to treat and sometimes in difficult situations, which will report more efficient and probably better tolerated combination therapies.
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https://dumas.ccsd.cnrs.fr/dumas-00905808
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Submitted on : Monday, November 18, 2013 - 4:48:23 PM
Last modification on : Tuesday, October 13, 2020 - 2:42:01 PM
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Marie Feillant. Traitement de l'hépatite C en 2011-2013 : les résultats dans la "vraie vie" à l'heure de la trithérapie. Hépatologie et Gastroentérologie. 2013. ⟨dumas-00905808⟩

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