J Clin Transl Hepatol. 2024 Jul 28;12(7):646-658. doi: 10.14218/JCTH.2024.00089.Epub 2024 Jun 17.
Fanpu Ji 1, Sally Tran 2, Eiichi Ogawa 3, Chung-Feng Huang 4 5, Takanori Suzuki 6, Yu Jun Wong 7 8, Hidenori Toyoda 9, Dae Won Jun 10 11, Liu Li 12, Haruki Uojima 13, Akito Nozaki 14, Makoto Chuma 14, Cheng-Hao Tseng 15, Yao-Chun Hsu 15, Masatoshi Ishigami 16, Takashi Honda 16, Masanori Atsukawa 17, Hiroaki Haga 18, Masaru Enomoto 19, Huy Trinh 20, Carmen Monica Preda 21, Phillip Vutien 22, Charles Landis 22, Dong Hyun Lee 23, Tsunamasa Watanabe 24, Hirokazu Takahashi 25 26, Hiroshi Abe 27, Akira Asai 28, Yuichiro Eguchi 25 29, Jie Li 30, Xiaozhong Wang 31, Jia Li 32, Junping Liu 33, Jing Liang 34, Carla Pui-Mei Lam 35, Rui Huang 30, Qing Ye 34, Hongying Pan 36, Jiajie Zhang 36, Dachuan Cai 37, Qi Wang 38, Daniel Q Huang 39 40, Grace Wong 41 42, Vincent Wai-Sun Wong 41, Junyi Li 12, Son Do 43, Norihiro Furusyo 44, Makoto Nakamuta 45, Hideyuki Nomura 46, Eiji Kajiwara 47, Eileen L Yoon 10 11, Sang Bong Ahn 48, Koichi Azuma 49, Kazufumi Dohmen 50, Jihyun An 51, Do Seon Song 52, Hyun Chin Cho 53, Akira Kawano 54, Toshimasa Koyanagi 55, Aritsune Ooho
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Abstract
Background and aims: As practice patterns and hepatitis C virus (HCV) genotypes (GT) vary geographically, a global real-world study from both East and West covering all GTs can help inform practice policy toward the 2030 HCV elimination goal. This study aimed to assess the effectiveness and tolerability of DAA treatment in routine clinical practice in a multinational cohort for patients infected with all HCV GTs, focusing on GT3 and GT6.
Methods: We analyzed the sustained virological response (SVR12) of 15,849 chronic hepatitis C patients from 39 Real-World Evidence from the Asia Liver Consortium for HCV clinical sites in Asia Pacific, North America, and Europe between 07/01/2014-07/01/2021.
Results: The mean age was 62±13 years, with 49.6% male. The demographic breakdown was 91.1% Asian (52.9% Japanese, 25.7% Chinese/Taiwanese, 5.4% Korean, 3.3% Malaysian, and 2.9% Vietnamese), 6.4% White, 1.3% Hispanic/Latino, and 1% Black/African-American. Additionally, 34.8% had cirrhosis, 8.6% had hepatocellular carcinoma (HCC), and 24.9% were treatment-experienced (20.7% with interferon, 4.3% with direct-acting antivirals). The largest group was GT1 (10,246 [64.6%]), followed by GT2 (3,686 [23.2%]), GT3 (1,151 [7.2%]), GT6 (457 [2.8%]), GT4 (47 [0.3%]), GT5 (1 [0.006%]), and untyped GTs (261 [1.6%]). The overall SVR12 was 96.9%, with rates over 95% for GT1/2/3/6 but 91.5% for GT4. SVR12 for GT3 was 95.1% overall, 98.2% for GT3a, and 94.0% for GT3b. SVR12 was 98.3% overall for GT6, lower for patients with cirrhosis and treatment-experienced (TE) (93.8%) but ≥97.5% for treatment-naive patients regardless of cirrhosis status. On multivariable analysis, advanced age, prior treatment failure, cirrhosis, active HCC, and GT3/4 were independent predictors of lower SVR12, while being Asian was a significant predictor of achieving SVR12.
Conclusions: In this diverse multinational real-world cohort of patients with various GTs, the overall cure rate was 96.9%, despite large numbers of patients with cirrhosis, HCC, TE, and GT3/6. SVR12 for GT3/6 with cirrhosis and TE was lower but still excellent (>91%).a
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