{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T00:06:35Z","timestamp":1705277195707},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T00:00:00Z","timestamp":1552867200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"award":["Dr.-Liselotte-Brauns-Forschungspreis f\u00fcr Innere M"],"award-info":[{"award-number":["Dr.-Liselotte-Brauns-Forschungspreis f\u00fcr Innere M"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Direct\u2010acting antiviral (DAA) therapies have revolutionized the treatment of chronic hepatitis C virus infection, achieving sustained virological response (SVR) rates of\u00a0&gt;90% even in patients with advanced liver cirrhosis. Having observed an unusual case of repeated DAA therapy failures in a patient with a transjugular intrahepatic portosystemic shunt (TIPS), we assessed a possible association between prior TIPS placement and DAA failure. A structured search of our clinical database revealed 10 patients who had received DAA therapy after TIPS placement. At the time of therapy, most patients (8; 80%) presented with a Child\u2010Pugh score B, and the following DAA regimens were used: sofosbuvir\/ledipasvir \u00b1 ribavirin (5 patients), sofosbuvir\/daclatasvir \u00b1 ribavirin (3), sofosbuvir\/velpatasvir (2), and sofosbuvir\/velpatasvir\/voxilaprevir (1). In total, 5 patients (50%) achieved an SVR, whereas a virological relapse occurred in the other half of the cases, including 2 patients with multiple relapses. In this patient cohort, SVR rates were unusually low for all regimens: sofosbuvir\/ledipasvir \u00b1 ribavirin, 3\/5 (60%); sofosbuvir\/daclatasvir \u00b1 ribavirin, 2\/3 (66%); sofosbuvir\/velpatasvir, 0\/2 (0%); and sofosbuvir\/velpatasvir\/voxilaprevir, 0\/1 (0%), and patients with a TIPS made up a relevant proportion of DAA failures in patients with cirrhosis at our center: sofosbuvir\/ledipasvir, 2\/18 (11%); sofosbuvir\/daclatasvir, 1\/4 (25%); sofosbuvir\/velpatasvir, 2\/3 (66%); and sofosbuvir\/velpatasvir\/voxilaprevir, 1\/1 (100%). <jats:italic toggle=\"yes\">Conclusion: <\/jats:italic>We observed a high rate of virological relapse in patients with a TIPS who received DAA treatment and therefore postulate that TIPS placement may be a possible risk factor for DAA failure due to the profound hemodynamic changes evoked by the intervention. Longer treatment duration or addition of ribavirin might be warranted in these patients.<\/jats:p>","DOI":"10.1002\/hep4.1337","type":"journal-article","created":{"date-parts":[[2019,3,18]],"date-time":"2019-03-18T17:35:43Z","timestamp":1552930543000},"page":"614-619","source":"Crossref","is-referenced-by-count":3,"title":["Transjugular Intrahepatic Portosystemic Shunt: A Possible Risk Factor for Direct\u2010Acting Antiviral Treatment Failure in Patients With Hepatitis C?"],"prefix":"10.1097","volume":"3","author":[{"given":"Felix","family":"Piecha","sequence":"first","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan\u2010Michael","family":"G\u00e4n\u00dfler","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Jordan","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Can","family":"Ergen","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Ittrich","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology and Nuclear Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Kluwe","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Pischke","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ansgar W.","family":"Lohse","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"},{"name":"German Center for Infection Research,Partner Site Hamburg\u2010L\u00fcbeck\u2010Borstel\u2010Riems,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Schulze zur Wiesch","sequence":"additional","affiliation":[{"name":"I. Department of Medicine,University Medical Center Hamburg\u2010Eppendorf,Hamburg,Germany"},{"name":"German Center for Infection Research,Partner Site Hamburg\u2010L\u00fcbeck\u2010Borstel\u2010Riems,Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,3,18]]},"reference":[{"key":"hep41337-bib-0001-20240114","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/1471-230X-14-87","article-title":"Safety and efficacy of protease inhibitor based combination therapy in a single\u2010center \u201creal\u2010life\u201d cohort of 110 patients with chronic hepatitis C genotype 1 infection","volume":"14","year":"2014","journal-title":"BMC Gastroenterol"},{"key":"hep41337-bib-0002-20240114","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.jhep.2018.03.026","article-title":"EASL recommendations on treatment of hepatitis C 2018","volume":"69","year":"2018","journal-title":"J Hepatol"},{"key":"hep41337-bib-0003-20240114","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1053\/j.gastro.2017.11.007","article-title":"Patterns of resistance\u2010associated substitutions in patients with chronic HCV infection following treatment with direct\u2010acting antivirals","volume":"154","year":"2018","journal-title":"Gastroenterology"},{"key":"hep41337-bib-0004-20240114","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1111\/j.1365-2125.2012.04284.x","article-title":"Trends in oral drug bioavailability following bariatric surgery: examining the variable extent of impact on exposure of different drug classes","volume":"74","year":"2012","journal-title":"Br J Clin Pharmacol"},{"key":"hep41337-bib-0005-20240114","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.jhep.2017.10.035","article-title":"Stomach reduction or gastric bypass as risk factor for treatment failure after DAA therapy for hepatitis C?","volume":"68","year":"2018","journal-title":"J Hepatol"},{"key":"hep41337-bib-0006-20240114","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1055\/s-0031-1273405","article-title":"German S 3\u2010guideline \u201cascites, spontaneous bacterial peritonitis, hepatorenal syndrome\u201d","volume":"49","year":"2011","journal-title":"Z Gastroenterol"},{"key":"hep41337-bib-0007-20240114","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1053\/jhep.2002.31722","article-title":"Hepatic arterial buffer response in patients with advanced cirrhosis","volume":"35","year":"2002","journal-title":"Hepatology"},{"key":"hep41337-bib-0008-20240114","doi-asserted-by":"crossref","first-page":"G179","DOI":"10.1152\/ajpgi.00239.2017","article-title":"Rapid change of liver stiffness after variceal ligation and TIPS implantation","volume":"314","year":"2018","journal-title":"Am J Physiol Gastrointest Liver Physiol"},{"key":"hep41337-bib-0009-20240114","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1056\/NEJMoa1613512","article-title":"POLARIS\u20101 and POLARIS\u20104 Investigators. 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