{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T07:13:59Z","timestamp":1763018039450,"version":"3.40.5"},"reference-count":42,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T00:00:00Z","timestamp":1561507200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["405211\/2016\u20103"],"award-info":[{"award-number":["405211\/2016\u20103"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["Bolsa de Inicia\u00e7\u00e3o Cient\u00edfica \u2010 2017\/2","235083"],"award-info":[{"award-number":["Bolsa de Inicia\u00e7\u00e3o Cient\u00edfica \u2010 2017\/2","235083"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006507","name":"Funda\u00e7\u00e3o Oswaldo Cruz","doi-asserted-by":"publisher","award":["Programa de Incentivo \u00e0 Jovens Pesquisadores INI","06.19"],"award-info":[{"award-number":["Programa de Incentivo \u00e0 Jovens Pesquisadores INI","06.19"]}],"id":[{"id":"10.13039\/501100006507","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Few studies have evaluated sustained virological response (SVR) rates by direct\u2010acting agents (DAAs) and liver stiffness measurement (LSM) changing post\u2010SVR in limited\u2010resource settings. We aimed to describe the effectiveness of DAAs for hepatitis C virus treatment and to assess the changing of LSM post\u2010SVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study analyzed data of consecutive hepatitis C virus\u2010infected patients treated by DAAs from 2015 to 2017 in two tertiary centers in Brazil. SVR rates were reported by intention\u2010to\u2010treat and per\u2010protocol analyses. LSM by transient elastography performed before treatment and post\u2010SVR was compared, and logistic regression models were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six hundred seventy\u2010one patients (63% female, 62\u00a0years [55\u201368], 89% genotype 1, 8% HIV co\u2010infected, and 64% with cirrhosis) were included. Most patients were treated by sofosbuvir\/daclatasvir\u00a0\u00b1\u00a0ribavirin (74%) and sofosbuvir\/simeprevir\u00a0\u00b1\u00a0ribavirin (21%). SVR rates (95% confidence interval [CI]) were 94.6% (92.7\u201396.1) and 97.8% (96.4\u201398.7) for intention\u2010to\u2010treat and per\u2010protocol analyses, respectively. The leading adverse event was anemia (9.6% [95% CI 7.6\u201312.1]). Pretreatment and post\u2010SVR12 LSM were available in 400 patients. LSM had significantly decreased after SVR (13.6\u00a0kPa [interquartile range, 10.0\u201321.6] <jats:italic>vs<\/jats:italic> 10.2\u00a0kPa [7.0\u201317.6], <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). A total of 167 patients (42%) decreased at least 30% of LSM post\u2010SVR. The absence of type 2 diabetes (odds ratio\u00a0=\u00a01.52 [95% CI 1.05\u20132.21], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.028) and presence of platelet count \u2265\u00a0150\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/mm<jats:sup>3<\/jats:sup> (odds ratio\u00a0=\u00a01.75 [1.23\u20132.50], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.002) were independently associated with a significant LSM regression (\u2265\u00a030%) post\u2010SVR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>DAAs were highly effective and safe, and LSM significantly decreased after SVR in a real\u2010life cohort in Brazil. The absence of type 2 diabetes and presence of high platelet count were independently associated with LSM decrease post\u2010SVR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14707","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T10:54:04Z","timestamp":1557226444000},"page":"2187-2195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Effectiveness of direct\u2010acting agents for hepatitis C and liver stiffness changing after sustained virological response"],"prefix":"10.1111","volume":"34","author":[{"given":"Flavia F","family":"Fernandes","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Department Bonsucesso Federal Hospital  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana","family":"Piedade","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Bonsucesso Federal Hospital  Rio de Janeiro Brazil"},{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livia","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Bonsucesso Federal Hospital  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estevao P","family":"Nunes","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Chaves","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafaela V","family":"Goldenzon","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra W","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana","family":"Duarte","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Bonsucesso Federal Hospital  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Grinsztejn","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valdilea G","family":"Veloso","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Department Bonsucesso Federal Hospital  Rio de Janeiro Brazil"},{"name":"School of Medicine, Est\u00e1cio de S\u00e1 University  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0931-6418","authenticated-orcid":false,"given":"Hugo","family":"Perazzo","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Research on STD\/AIDS Evandro Chagas National Institute of Infectious Disease (INI)\u2014Oswaldo Cruz Foundation (FIOCRUZ)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,6,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i32.11033"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2575"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.09.009"},{"key":"e_1_2_6_5_1","first-page":"CD012143","article-title":"Direct\u2010acting antivirals for chronic hepatitis C","author":"Jakobsen JC","year":"2017","journal-title":"Cochrane Database Syst. 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