Real-world experience with interferon-free, direct acting antiviral therapies in Asian Americans with chronic hepatitis C and advanced liver disease

Abstract

Real-life data on interferon (IFN)-free direct acting antiviral (DAA) therapies for chronic hepatitis C (CHC) is limited for Asian Americans.To evaluate sustained virologic response (SVR) and adverse events (AE) in Asian Americans treated with sofosbuvir (SOF)-based, IFN-free DAA therapies.This is a retrospective study of 110 consecutive Asian Americans with HCV genotypes 1 to 3 or 6 treated with IFN-free SOF-based regimens for 8 to 24 weeks between February 2014 and March 2016 at a university center in Northern California.Mean age was 63 ± 12 years, mean BMI was 25 ± 6 (kg/m2), and about half (52%) were male. Most patients were infected with HCV genotype 1 (HCV-1, 64%), followed by HCV-2 (14%), HCV-6 (13%), and HCV-3 (8%). Half had cirrhosis, and the majority of these (67%) had decompensation. Overall SVR12 was 93% (102/110), and highest among patients without cirrhosis, liver transplant, or HCC (100%, 37/37). SVR12 was lower among patients with HCC (82%, 14/17), decompensated cirrhosis (84%, 31/37), or liver transplant (89%, 17/19), regardless of treatment and genotype. Most common AEs were anemia (25%), fatigue (20%), and headache (12%). Anemia was highest in patients receiving SOF/RBV (67%). There was 1 treatment-unrelated serious adverse effect (SAE). There were 7 dose reductions due to anemia or fatigue from RBV and 2 treatment discontinuations due to fatigue or loss of insurance authorization.This real-life cohort of Asian American CHC patients treated with IFN-free SOF-based therapies showed high overall treatment response and good tolerability, despite very high rates of advanced disease and prior treatment failure.

Systematic review with meta‐analysis: effectiveness of direct‐acting antiviral treatment for hepatitis C in patients with hepatocellular carcinoma

“…Study characteristics were summarised in Tables and . Fifty‐six studies were included, with a total of 5522 patients with HCC, while 27 studies enrolled non‐HCC patients as control groups. Fifty‐three (95%) studies were observational cohorts (45 retrospective and eight prospective) and three studies were clinical trials.…”

Efficacy of generic oral directly acting agents in patients with hepatitis C virus infection

“…A study from Spain reported an overall SVR12 of 93.8% in genotype 3 patients treated with sofosbuvir and daclatasvir combination therapy . Another study in Asian American patients with CHC and advanced liver disease (genotypes 1, 2, 3 and 6), treated with multiple oral DAA combinations, reported a similar overall SVR . The SVR12 in CHC patients treated with sofosbuvir plus daclatasvir and ribavirin was lower than that of other combinations, possibly due to a small sample size of eight patients in this subgroup.…”

Real‐world effectiveness and safety of ledipasvir/sofosbuvir for genotype 6 chronic hepatitis C patients in Taiwan

“…Most involved fewer than 50 patients. They also presented a wide variation of treatment results, and the SVR rates ranged from 64.1% to 100% . In contrast, this study enrolled patients with a single HCV GT and the most GT6 CHC patients of any study in the literature; it was also conducted in a real‐world setting.…”

“…They also presented a wide variation of treatment results, and the SVR rates ranged from 64.1% to 100%. [19][20][21][22][23][24][25] In contrast, this study enrolled patients with a single HCV GT and the most GT6 CHC patients of any study in the literature; it was also conducted in a real-world setting. Therefore, the analysis of the realworld effectiveness and safety of DAA treatment for GT6 CHC in this study provides an important and useful reference not only for Taiwan but also for Southeast Asia.…”