Gut and Liver Comparison of the Clinical Characteristics and Outcomes between Leprosy-Affected Persons in Sorokdo and the General Population Affected by Chronic Hepatitis C in Korea
Author Information
Young-hwan Ahn 1, Hyungcheol Park 2, Myeon Jae Lee 3, Dong Hyun Kim 3, Sung Bum Cho 3, Eunae Cho 3, Chung hwan Jun 3* and Sung-Kyu Choi 3*
1Department of Internal Medicine, Sorokdo National Hospital, Goheung, South Korea, 2Department of Preventive Medicine, Sorokdo National Hospital, Goheung, South Korea, 3Department of Gastroenterology, Chonnam National University Hospital, Gwangju, South Korea

Chung Hwan Juna and Sung Kyu Choib
Department of Gastroenterology, Chonnam National University Hospital,
42 Jaebong-ro, Donggu, Gwangju 501-757, South Korea.
Tel: +82-62-220-6296, Fax: +82-62-220-8578, aE-mail: estevanj@naver.com and bE-mail:choisk@jnu.ac.kr
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: Patients with Hansen’s disease are the most vulnerable to hepatitis C; however, no data on the treatment efficacy of direct-acting antiviral agents (DAAs) are available in this group. Therefore, we elucidated the prevalence and clinical outcomes of hepatitis C in persons affected by leprosy in Sorokdo, Jeollanam-do, Korea. Methods: We retrospectively included 50 leprosy patients with positive hepatitis C virus (HCV) RNA test results (group A) hospitalized at the Sorokdo National Hospital from May 2016 to March 2018 and 73 patients with chronic hepatitis C who were treated with DAAs at the Chonnam National University Hospital (group B) from May 2016 to December 2017. Results: Overall, at the Sorokdo National Hospital, positive HCV antibody and HCV RNA rates were 18.4% and 11%, respectively. The mean participant age was 76.5±7 years, and 58% of participants were males. The genotype incidence was 22 out of 50 (44%) for genotype 1b and 28 out of 50 (56%) for genotype 2. Sustained virologic response was achieved at a rate of 95.5% (21/22) in genotype 1b and 92.9% (26/28) in genotype 2 patients. Ribavirin-induced hemolytic anemia occurred in 57.1% (16/28) of patients with genotype 2. Among these, 28.5% (8/28) received blood transfusions. Conclusions: Treatment efficacy was not different between the leprosy-affected population and the general population. However, ribavirin-induced severe hemolytic anemia requiring transfusion was present in 28.5% of genotype 2 patients. Therefore, we suggest ribavirin-free DAAs for the treatment of genotype 2 hepatitis C in leprosy-affected persons in the future.
Keywords: Hepatitis C, chronic; Antiviral agents; Leprosy
Abstract
Background/Aims: Patients with Hansen’s disease are the most vulnerable to hepatitis C; however, no data on the treatment efficacy of direct-acting antiviral agents (DAAs) are available in this group. Therefore, we elucidated the prevalence and clinical outcomes of hepatitis C in persons affected by leprosy in Sorokdo, Jeollanam-do, Korea. Methods: We retrospectively included 50 leprosy patients with positive hepatitis C virus (HCV) RNA test results (group A) hospitalized at the Sorokdo National Hospital from May 2016 to March 2018 and 73 patients with chronic hepatitis C who were treated with DAAs at the Chonnam National University Hospital (group B) from May 2016 to December 2017. Results: Overall, at the Sorokdo National Hospital, positive HCV antibody and HCV RNA rates were 18.4% and 11%, respectively. The mean participant age was 76.5±7 years, and 58% of participants were males. The genotype incidence was 22 out of 50 (44%) for genotype 1b and 28 out of 50 (56%) for genotype 2. Sustained virologic response was achieved at a rate of 95.5% (21/22) in genotype 1b and 92.9% (26/28) in genotype 2 patients. Ribavirin-induced hemolytic anemia occurred in 57.1% (16/28) of patients with genotype 2. Among these, 28.5% (8/28) received blood transfusions. Conclusions: Treatment efficacy was not different between the leprosy-affected population and the general population. However, ribavirin-induced severe hemolytic anemia requiring transfusion was present in 28.5% of genotype 2 patients. Therefore, we suggest ribavirin-free DAAs for the treatment of genotype 2 hepatitis C in leprosy-affected persons in the future.
Keywords: Hepatitis C, chronic; Antiviral agents; Leprosy
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