• Fátima Falcão, Carla Lopes, Erica Viegas, Rita Perez, Isabel Aldir, Helena Farinha, António Carvalho, Ana Mirco, Susana Marques, Tiago Bana E Costa, Ana Cláudia Miranda, Luís Lebre, Paula Peixe, Cristina Chagas, Kamal Mansinho, and José Manuel Correia.
• Pharmacy and Therapeutics Committee. Centro Hospitalar de Lisboa Ocidental. Lisboa; Pharmacy Department. Centro Hospitalar de Lisboa Ocidental. Lisboa; Department of Pharmacy Practice. Faculty of Pharmacy. University of Lisbon. Lisboa. Portugal.
• Acta Medica Port. 2019 Mar 29; 32 (3): 189-194.

IntroductionIn late 2014, Portugal implemented a national program for the treatment of patients with chronic hepatitis C with directacting antiviral agents. This program has made Portugal one of the first European countries to implement a structured measure of treatment to eliminate this serious public health problem. The aim of this study was to assess the effectiveness of direct-acting antiviral therapy in the treatment of patients with chronic hepatitis C virus infection.Material And MethodsA retrospective observational study was conducted at Centro Hospitalar de Lisboa Ocidental on the national online platform from December 2014 until February 2017 and included patients with hepatitis C virus infection who underwent treatment. The primary endpoint was sustained virologic response at least 12 weeks post treatment. Data was analyzed with the SPSS 17.0 program.ResultsDuring the study period, 820 patients completed therapy and achieved sufficient follow-up time to assess sustained virologic response with an overall response rate of 97.2% (n = 797) and a response rate of 98.0%, 99.5%, 90.9%, 95.1% and 94.2% for genotypes 1a, 1b, 2, 3 and 4, respectively. Data suggested that advanced fibrosis (F3/F4), human immunodeficiency virus co-infection and treatment failure with interferon and ribavirin were not negatively related with sustained virologic response in our population. Most patients (80.1%) completed treatment with ledipasvir/sofosbuvir ± ribavirin. The most common adverse events were fatigue and insomnia followed by headache and weight loss.DiscussionPatients predominantly had genotype 1 infection which correlates with HCV distribution in Europe, but we found a major proportion in genotype 4 which can be explained by immigration from African countries. Our patients' ages ranging from 22 to 90 years, reflected a new approach with no upper age limit. Direct-acting antivirals regimens resulted in remarkably high SVR rates compared to interferon-based regimens, which were consistent with clinical trials data.ConclusionOur data showed that direct-acting antiviral-based regimens are safe and have a high success rate in the treatment of patients with hepatitis C virus infection in a real-world setting.

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