Direct-acting antivirals in East Asian hepatitis C patients: real-world experience from the REAL-C Consortium.
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Huang Chung-Feng, Iio Etsuko, Jun Dae Won, Ogawa Eiichi, Toyoda Hidenori, Hsu Yao-Chun, Haga Hiroaki, Iwane Shinji, Enomoto Masaru, Lee Dong Hyun, Wong Grace, Liu Chen-Hua, Tada Toshifumi, Chuang Wan-Long, Cheung Ramsey, Hayashi Jun, Tseng Cheng-Hao, Yasuda Satoshi, Tran Sally, Kam Leslie, Henry Linda, Jeong Jae Yoon, Nomura Hideyuki, Park Seung Ha, Nakamuta Makoto, Huang Jee-Fu, Tai Chi-Ming, Lo Gin-Ho, Lee Mei-Hsuan, Yang Hwai-I, Kao Jia-Horng, Tamori Akihiro, Eguchi Yuichiro, Ueno Yoshiyuki, Furusyo Norihiro, Tanaka Yasuhito, Yu Ming-Lung, Nguyen Mindie H, REAL-C Investigators
Аннотация
METHODS: Chronic hepatitis C (CHC) patients from clinical sites in Japan, Taiwan, South Korea, and Hong Kong were recruited in the REAL-C registry, an observational chart review registry. The primary outcome was sustained virologic response (SVR12, HCV RNA PCR < 25 IU/mL 12 week post-therapy).
RESULTS: A total of 6287 CHC patients were enrolled. Compared to other East Asian patients, patients from Japan were older (66.3 vs. 61.5 years, p < 0.0001), had lower body mass indices (22.9 kg/m2 vs. 24.6 kg/m2, p < 0.001), and were more likely to have non-liver malignancy history (12.2% vs. 5.0%, p < 0.001).The overall SVR12 rate was 96.4%, similar to patients both inside and outside Japan (96.6% vs. 96%, p = 0.21). The SVR12 rate ranged from 91.1 to 99.4% except treatment-experienced cirrhotic HCV genotype-1 patients who received daclatasvir/asunaprevir (85.9%) and the treatment-experienced cirrhotic HCV genotype-2 patients treated with sofosbuvir/ribavirin (87%). The overall rate of drug discontinuation was 1.9%, also similar across regions. On multivariate regression analyses, there was no significant association between geographic region and SVR outcomes.
CONCLUSIONS: In this large multinational CHC cohort from the East Asia, oral DAAs were highly effective and well tolerated across the region. Policies should encourage treatment for all CHC patients with DAAs in Asia with its heavy burden of HCV.