HCV AND HEPATITIS HCV epidemiology and treatment failure Arevir - - PowerPoint PPT Presentation

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HCV AND HEPATITIS HCV epidemiology and treatment failure Arevir - - PowerPoint PPT Presentation

Feb 12, 2023 364 likes •635 views

HCV AND HEPATITIS HCV epidemiology and treatment failure Arevir meeting, 04.05.2019 | Saleta Sierra Geno2pheno [HCV] Team Geno2pheno [HCV] USAGE Geno2pheno [HCV] USAGE PEPSI Study in numbers 2882 Patienten 4759 Proben 46 DAA-therapy

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SLIDE 1

HCV AND HEPATITIS

Arevir meeting, 04.05.2019 | Saleta Sierra

HCV epidemiology and treatment failure

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SLIDE 2

Geno2pheno[HCV] Team

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SLIDE 3

Geno2pheno[HCV] USAGE

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SLIDE 4

Geno2pheno[HCV] USAGE

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SLIDE 5

PEPSI Study in numbers

  • 2882 Patienten
  • 4759 Proben
  • 46 DAA-therapy failing patients
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SLIDE 6

PEPSI PROJECT MAIN CONTRIBUTORS

Zentrum Abkürzung Stadt N Dres Isernhagen/Qurishi/Römer, Köln I1 Köln 541 Uniklinik Köln CGN1 Köln 457 mib Dienstleistung GmbH B3 Berlin 439 Uniklinik Düsseldorf DUS1 Düsseldorf 246

  • Prof. Dr. Goeser, Uniklinik Köln

F1G Köln 245 Hepatitis-Ambulanz, Uniklinik Düsseldorf PO1 Düsseldorf 206

  • Dr. Peuser, Lüdenscheid

P4 Lüdenscheid 106

  • Dres. Scholten und Schneeweiss, Köln

S8 Köln 105

  • Dr. Niels Schübel, Klinikum Osnabrück

M4 Osnabrück 98 MX01-Ambulanz, Uniklinik Düsseldorf O1 Düsseldorf 78

  • Dr. Christensen, Münster

C2 Münster 76 Virologie Düsseldorf DUSV Düsseldorf 64

  • Dr. Kwirant, Duisburg

K3 Duisburg 54 Hower, Klinikum Dortmund D1 Dortmund 46

  • Dr. Carls, Düsseldorf

C3 Düsseldorf 36

  • Dr. Postel, München

P5 München 27

  • PD. Dr. Sagir, Bethesda, Duisburg

D2 Duisburg 27 Medizinische Hochschule Hannover C4 Hannover 24

  • Fachb. Virushepatologie, UKE, Hamburg

H5 Hamburg 21 Poliklinik I, Uniklinik Bonn BN1 Bonn 18

  • Med. I, Haus 16, Uniklinik Köln

F1 Köln 16 Praxis am Ebertplatz, Köln T1 Köln 15

  • Dr. Schäfer, Bielefeld

S3 Bielefeld 11 Virologie Essen E2 Essen 10 HPSTD-Ambulanz, Uniklinik Essen E1 Essen 10

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SLIDE 7

PEPSI AS PART OF EUROPEAN GT PROJECT

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SLIDE 8

EU (+RUS, +ISL) GT ANALYSIS

N = 37839, 52 centres

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SLIDE 9

EU (+RUS, +ISL) GT DISTRIBUTION

4,8 20,9 9,0 0,2 0,1 10,5 25,6 28,9 64,9

GT2 GT3 GT4 GT5 GT6 GT1 GT1a GT1b

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SLIDE 10

PEPSI PROJECT GT PREVALENCE (N=2207)

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SLIDE 11

EU (+RUS, +ISL) GT DISTRIBUTION

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

TOTAL España Italia Portugal Alemania Bélgica UK Israel Lux Rusia Austria

GT1b GT1a GT1 GT6 GT5 GT4 GT3 GT2

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SLIDE 12

GT DISTRIBUTION PER GENDER

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

hombre mujer

GT6 GT5 GT4 GT3 GT2 GT1b GT1a GT1

men women

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SLIDE 13

GT DISTRIBUTION PER CO-INFECTION

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

HIV + HIV - HBV + HBV -

GT6 GT5 GT4 GT3 GT2 GT1b GT1a GT1

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SLIDE 14

GT DISTRIBUTION PER AGE

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

≥65 64-55 54-45 44-35 34-25 24-15 ≤14

GT6 GT5 GT4 GT3 GT2 GT1b GT1a GT1

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SLIDE 15

GT DISTRIBUTION PER TRANSMISSION ROUTE

parenteral vertical nosocomial tattoo / piercing adicción drogas sexual MSM

GT6 GT5 GT4 GT3 GT2 GT1b GT1a GT1

Drugs

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GT DISTRIBUTION

GTs 2 and 1b ; GT4 increasing in other countries Epidemiology:

  • Females, > 60 years, nosocomial infection: GTs 1b or 2
  • Males, < 45-50 years, on drugs: GTs 1a, and/or 3
  • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4
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SLIDE 17

GT DISTRIBUTION

GTs 2 and 1b ; GT4 increasing in other countries Epidemiology:

  • Females, > 60 years, nosocomial infection: GTs 1b or 2
  • Males, < 45-50 years, on drugs: GTs 1a, and/or 3
  • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4

Limitations of the study:

  • Geographical coverage
  • Subtype NOT available when using commercial kits

− Recombinants

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SLIDE 18

HCV RECOMBINANTS

DAA & sequence-based genotyping

targets conventional genotyping targets

[1] Galli & Bukh. Trends Microbiol. 2014. 22: 354; [2] Kurata et al. Hepatol Res. 2017;[3] Iles et al. J. Clin Microbiol 53: 3155; [4] Gaspareto et al Arch Virol 2016 161: 2161

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SLIDE 19

GT DISTRIBUTION

GTs 2 and 1b ; GT4 increasing in other countries Epidemiology:

  • Females, > 60 years, nosocomial infection: GTs 1b or 2
  • Males, < 45-50 years, on drugs: GTs 1a, and/or 3
  • MSM, < 45-50 years, HIV+: GTs 1a, and/or 4

Limitations of the study:

  • Geographical coverage
  • Subtype NOT available when using commercial kits

− Recombinants − “Exotic” subtypes

  • Limited epidemiological parameters collection (transmission)
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THERAPY FAILURE: 46 PATIENTS

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THERAPY FAILURE: 46 PATIENTS

  • 1a(I)

1a(II) 1b 3a 3b 4d 4k 4n 4r

GT N undetermined 4 1a(I) 6 1a(II) 11 1b 11 3a 8 3b 1 4d 2 4k 1 4n 1 4r 1 Total 46

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THERAPY FAILURE: 46 THERAPIES

Regimen N 3D 6 3D, RBV 1 GLE, PIB 2 GRZ, EBV 3 HRV 19 pIFN, RBV, BOC 2 pIFN, RBV, DCV 1 pIFN, RBV, SOF 2 pIFN, RBV, TVR 2 RBV, HRV 1 RBV, SMV, SOF 1 RBV, SOF 2 RBV, SOF, VEL 1 SOF, VEL 3 Total 46

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THERAPY FAILURE: RAMs

RAMs N no sequence no 19 yes 23 Total 42 Gene N NS3 2 NS3, NS5A 1 NS3, NS5A, NS5B 2 NS5A 16 NS5B 2 Total 23

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SLIDE 24

THERAPY FAILURE: RAMs

RAMs N no sequence no 19 yes 23 Total 42 Gene N NS3 2 NS3, NS5A 1 NS3, NS5A, NS5B 2 NS5A 16 NS5B 2 Total 23

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SLIDE 25

THANKS

AG Kaiser: Rolf Kaiser, Elena Knops, Eva Heger, Veronica di Cristanziano, Claudia Müller, Max Demagnez, Roland Schmidt, Kati Hutt, Michael Böhm, Heike Kulartz, Lisa Hüsgen

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SLIDE 26

THANKS

To you !!