Direct-acting antivirals in East Asian hepatitis C patients: real-world experience from the REAL-C Consortium

• DOI: 10.1007/s12072-019-09974-z
• Publication Date: 2019-08-28T15:44:20Z
• Authors: Chung-Feng Huang; Etsuko Iio; Dae Won Jun; Eiichi Ogawa; Hidenori Toyoda; Yao-Chun Hsu; Hiroaki Haga; Shinji Iwane; Masaru Enomoto; Dong Hyun Lee; Grace Wong; Chen-Hua Liu; Toshifumi Tada; Wan-Long Chuang; Ramsey Cheung; Jun Hayashi; Cheng-Hao Tseng; Satoshi Yasuda; Sally Tran; Leslie Kam; Linda Henry; Jae Yoon Jeong; Hideyuki Nomura; Seung Ha Park; Makoto Nakamuta; Jee-Fu Huang; Chi-Ming Tai; Gin-Ho Lo; Mei-Hsuan Lee; Hwai-I Yang; Jia-Horng Kao; Akihiro Tamori; Yuichiro Eguchi; Yoshiyuki Ueno; Norihiro Furusyo; Yasuhito Tanaka; Ming-Lung Yu; Mindie H. Nguyen
• Keywords: Male; 0301 basic medicine; Sulfonamides; Pyrrolidines; Imidazoles; Taiwan; Middle Aged; Isoquinolines; Antiviral Agents; Hepatitis C; 3. Good health; 03 medical and health sciences; Treatment Outcome; Japan; Republic of Korea; Ribavirin; Hong Kong; Humans; Drug Therapy, Combination; Female; Carbamates; Sofosbuvir; Aged

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.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).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.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.