Eventos adversos de antivirais de ação direta no tratamento de pacientes com hepatite crônica C em serviços de referência de Salvador, Bahia

Abstract

Hepatitis C virus (HCV) infection is a relevant public health problem today, since it is a silent disease, with a late diagnosis and a high risk of chronification. It is currently one of the leading causes of chronic liver disease worldwide, bringing long-term damage to the lives of infected individuals. Therapy was based on the use of INF-α and Ribavirin (RBV), however, due to the limited efficacy and several adverse effects of these drugs, new, more effective and better-tolerated direct-acting antivirals were developed. Objective: To evaluate the frequency of adverse events of the new direct acting antivirals in patients with chronic hepatitis C according to the therapeutic response in hepatology service treated by specialized teams in the Viral Hepatitis Clinic of the Roberto Santos Hospital. Methods: This is a cross section study with a descriptive analysis of the data, whose data collection took place through the completion of a clinical record with information extracted from the patient records that are being followed up at the outpatient clinic for viral hepatitis at the Roberto Santos Hospital, Hospital São Rafael and University Hospital Complex Professor Edgard Santos (HUPES) in the period between 17/11/2017 to 30/06/2018. Results: A total of 74 patients were included, 39 (52,7%) males and 35 (47,3%) females, with a mean age of 60.3 years, 79.7% presenting genotype 1 and 20, 3% genotype 3, 91% of the patients who underwent treatment had RVS at 12 weeks after the end of treatmentOf these, 25 presented adverse events related to drug use. The most frequent adverse events described were: Headache (16.8%); Pruritus (14.7%); Dizziness (8,4%); Nausea (8.4%); Tiredness (6,3%) Papules (6,3%) and Lichenification of the skin (6,3%). In the group that reported adverse events, there was a predominance of female 60% (N = 15). Among the direct-acting antivirals used in patients with adverse events, 36% used sofosbuvir-daclatasvir-RBV; 32% sofosbuvir-daclatasvir; 24% sofosbuvir-simeprevir and 8% sofosbuvir-simprevir and RVB. Of the patients that participated in the study, 66,1% did not present adverse events. No serious adverse events were identified in the study and there was no interruption of treatment. Conclusion: In this sample of patients with chronic hepatitis, adverse events were observed at a lower frequency and without events considered serious. The data, corroborate with findings described in the literature.