BMC infectious diseases · 2025
Assessment of direct-acting antiviral treatment outcomes in patients with chronic hepatitis C infected with various HCV genotypes: Insights from a real-world cohort in West Bengal, India.
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Dutta Supradip, Nath Shreyasi, Das Raina, Bakshi Sagnik, Majumdar Moumita, Ghosh Anwesha, Baskey Upasana, Chowdhury Prosanto Kumar, Sadhukhan Provash Chandra
Аннотация
BACKGROUND & OBJECTIVES: Genomic diversity of Hepatitis C Virus (HCV), accessibility and long-term influence of Direct Acting Antiviral (DAA) treatment remain underexplored among HCV-infected chronic liver disease (CLD) patients in the real world. This retrospective study addressed the inadequacy of assessing the effectiveness of DAA and identify genotype-specific variations in treatment response in the context of HCV epidemiology. Additionally, real-world treatment challenges encountered during the COVID-19 pandemic and the transitional phase of implementing the National Viral Hepatitis Control Program (NVHCP) guidelines have also been addressed.
METHODS: This retrospective study included 254 CLD patients from November 2017 and February 2020 to assess the effectiveness of DAA and long-term treatment outcomes among CLD patients.
RESULTS: HCV viremia was observed in 58.26% (n = 148) patients. Patients aged 52-59 years with a history of blood transfusions exhibited a higher prevalence of active HCV infection. Two major genotypes (GT) - GT1 and GT3, and seven subtypes with few new subtypes were identified. SVR24 was achieved in 89.6% of patients receiving sofosbuvir (SOF) + daclatasvir (DCV) or SOF/ledipasvir (LDV) drug regimens. For individuals who failed to reach SVR24 (n = 13), a modified regimen (SOF + Velpatasvir (VEL) + ribavirin (Riba) for 6 months) was given and the success rate was 92.31%. GT-1a and GT-1b showed better treatment response, whereas GT-3b had a lower treatment response. Among 77 SVR24 achieved patients, 57.14% were cirrhotic and 42.86% were non-cirrhotic at the start of the therapy.
INTERPRETATION & CONCLUSION: This study highlights genotype-specific variations in treatment response, with GT-3b exhibiting lower treatment response which highlights the need to decipher the reasons behind treatment failure for future therapeutic management.
METHODS: This retrospective study included 254 CLD patients from November 2017 and February 2020 to assess the effectiveness of DAA and long-term treatment outcomes among CLD patients.
RESULTS: HCV viremia was observed in 58.26% (n = 148) patients. Patients aged 52-59 years with a history of blood transfusions exhibited a higher prevalence of active HCV infection. Two major genotypes (GT) - GT1 and GT3, and seven subtypes with few new subtypes were identified. SVR24 was achieved in 89.6% of patients receiving sofosbuvir (SOF) + daclatasvir (DCV) or SOF/ledipasvir (LDV) drug regimens. For individuals who failed to reach SVR24 (n = 13), a modified regimen (SOF + Velpatasvir (VEL) + ribavirin (Riba) for 6 months) was given and the success rate was 92.31%. GT-1a and GT-1b showed better treatment response, whereas GT-3b had a lower treatment response. Among 77 SVR24 achieved patients, 57.14% were cirrhotic and 42.86% were non-cirrhotic at the start of the therapy.
INTERPRETATION & CONCLUSION: This study highlights genotype-specific variations in treatment response, with GT-3b exhibiting lower treatment response which highlights the need to decipher the reasons behind treatment failure for future therapeutic management.