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Comorbidities and concomitant medications in patients with chronic hepatitis C virus infection receiving second-generation direct-acting antiviral regimens in Belgium : an observational study

Journal Volume 84 - 2021
Issue Fasc.1 - Original articles
Author(s) S. Bourgeois 1, JP. Mulkay 2, M. Cool 3, X. Verhelst 4, G. Robaeys 5 6, L. Lasser 7, V. Lefebvre 8, I. Colle 9, C. Van Steenkiste 10 11, J. Decaestecker 12, S. Coulon 13, K. Venken 13, T. Vanwolleghem 11 14
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Affiliations:
(1) Department of Gastroenterology and Hepatology, ZNA Antwerp, Antwerp, Belgium
(2) Department of Gastroenterology and Hepatology, CHU Saint-Pierre, Brussels,Belgium
(3) Department of Gastroenterology and Hepatology, AZ Damiaan, Ostend, Belgium
(4) Department of Gastroenterology and Hepatology, Ghent University Hospital, Ghent, Belgium
(5) Department of Gastroenterology and Hepatology, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium
(6) Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium
(7) Department of Gastroenterology and Hepatology, CHU Brugmann, Brussels, Belgium
(8) Department of Gastroenterology and Hepatology, CHR Namur, Namur, Belgium
(9) Department of Gastroenterology and Hepatology, Algemeen Stedelijk Ziekenhuis Aalst, Belgium and Ghent University, Ghent, Belgium
(10) Department of Gastroenterology and Hepatology, AZ Maria Middelares, Ghent, Belgium
(11) Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium
(12) Department of Gastroenterology and Hepatology, AZ Delta, Roeselare, Belgium
(13) Medical Affairs Department, MSD, Belgium, Brussels, Belgium
(14) Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium

Objective: To describe comorbidities and concomitant medications in patients initiating treatment for hepatitis C virus (HCV) infection with direct-acting antiviral (DAA) regimens in Belgium.

Methods: This was a noninterventional, observational, multicenter study of data from patient charts. Adult patients with HCV infection receiving second-generation DAA therapy were included. Comorbidities were assessed at the time of HCV treatment initiation. Concomitant medications were recorded at the time of diagnosis and at treatment initiation. Potential clinically relevant drug-drug interactions (DDIs) were assessed based on information available at www.hep-druginteractions.org. The primary objective was to describe concomitant medication use ; secondary objectives were to describe modifications in concomitant therapies and comorbidities.

Results: 405 patients were included. A total of 956 comorbidities were reported by 362 patients (median, 2 ; range, 0-15). The most common comorbidities were hypertension (27.2%) ; HIV coinfection (22.5%), and type 2 diabetes mellitus (14.3%). Overall, 1455 concomitant medications were being taken by 365 patients (90.1% ; median, 3 ; range 0-16). The most common concomitant medications were psycholeptics (28.6%), antiviral agents (24.2%), and medications for acid-related disorders (21.0%) Overall, 74/365 (20.3%) patients receiving a concomitant medication required an adaptation to their concomitant medication. The medications that most frequently required change were drugs for acid-related disorders (n = 14) and antiviral drugs (n = 5) ; those that were most frequently stopped were lipid-modifying drugs (n = 25) and drugs for acid-related disorders (n = 13).

Conclusion: Physicians are aware of the potential for DDIs with DAAs, but improved alignment between clinical practice and theoretical recommendations is required.

Keywords: Belgium, co-medication, direct-acting antivirals, drug–drug interactions, hepatitis C.

© Acta Gastro-Enterologica Belgica.
PMID 33639691