Direct-acting antivirals in East Asian hepatitis C patients: real-world experience from the REAL-C Consortium
Journal
Hepatology International
Journal Volume
13
Journal Issue
5
Pages
587-598
Date Issued
2019
Author(s)
Huang C.-F.
Iio E.
Jun D.W.
Ogawa E.
Toyoda H.
Hsu Y.-C.
Haga H.
Iwane S.
Enomoto M.
Lee D.H.
Wong G.
Tada T.
Chuang W.-L.
Cheung R.
Hayashi J.
Tseng C.-H.
Yasuda S.
Tran S.
Kam L.
Henry L.
Jeong J.Y.
Nomura H.
Park S.H.
Nakamuta M.
Huang J.-F.
Tai C.-M.
Lo G.-H.
Lee M.-H.
Yang H.-I.
Tamori A.
Eguchi Y.
Ueno Y.
Furusyo N.
Tanaka Y.
Yu M.-L.
Nguyen M.H.
For the REAL-C Investigators
Abstract
Background and aims: One-third of the global hepatitis C virus (HCV) burden is found in Asia. Real-world data from diverse East Asian cohorts remain limited. This study addressed the real-world status of direct-acting antiviral (DAA) therapy among patients from East Asia. 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. ? 2019, Asian Pacific Association for the Study of the Liver.
SDGs
Other Subjects
asunaprevir; daclatasvir; ribavirin; sofosbuvir; antivirus agent; asunaprevir; daclatasvir; imidazole derivative; isoquinoline derivative; ribavirin; sofosbuvir; sulfonamide; adult; aged; antiviral therapy; Article; body mass; chronic hepatitis C; controlled study; drug response; East Asian; female; genotype; geographic distribution; Hong Kong; human; Japan; liver cirrhosis; major clinical study; male; medical history; observational study; polymerase chain reaction; priority journal; South Korea; sustained virologic response; Taiwan; combination drug therapy; hepatitis C; middle aged; treatment outcome; Aged; Antiviral Agents; Drug Therapy, Combination; Female; Hepatitis C; Hong Kong; Humans; Imidazoles; Isoquinolines; Japan; Male; Middle Aged; Republic of Korea; Ribavirin; Sofosbuvir; Sulfonamides; Taiwan; Treatment Outcome
Publisher
Springer
Type
journal article