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Findings from a large Asian chronic hepatitis C real‐life study
Author(s) -
Lim Seng Gee,
Phyo Wah Wah,
Shah Samir R.,
Win Khin Maung,
Hamid Saeed,
Piratvisuth Teerha,
Tan Soek Siam,
Dan Yock Young,
Lee Yin Mei,
Ahmed Taufique,
Yang Wei Lyn,
Chen Kok Pun,
Kamat Mrunal,
Wadhawan Manav,
Madan Kaushal,
Mehta Rajiv,
Shukla Akash,
Dhore Prashant,
Eapen Chundamannil E.,
Abraham Priya,
Tyagi Satyendra,
Koshy Abraham,
Bwa Aung Hlaing,
Jafri Wasim,
Abid Shahab,
Arisar Fakhar Ali Qazi,
Tanwandee Tewesak,
Yin Thing Phee,
Tee Hoi Poh,
Hj Md Said Rosaida Binti,
Goh Khean Lee,
Ho Shiaw Hooi,
Mohamed Rosmawati,
Abu Bakar Norasiah
Publication year - 2018
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12989
Subject(s) - sofosbuvir , medicine , ledipasvir , cirrhosis , ribavirin , gastroenterology , chronic hepatitis , multivariate analysis , immunology , virus
Summary There is a paucity of information on chronic hepatitis C ( CHC ) patients treated with direct antiviral agents ( DAA s) in Asia. We invited Asia‐Pacific physicians to collate databases of patients enrolled for CHC treatment, recording baseline clinical, virologic and biochemical characteristics, sustained virologic response at week 12 ( SVR 12) and virologic failure. SVR 12 outcome was based on intention to treat ( ITT ). Multivariate analysis was used to assess independent risk factors for SVR 12 using SPSS version 20. A total of 2171 patients from India (n = 977), Myanmar (n = 552), Pakistan (n = 406), Thailand (n = 139), Singapore (n = 72) and Malaysia (n = 25) were collected. At baseline, mean age was 49 years, 50.2% were males, and 41.8% had cirrhosis. Overall, SVR 12 was 89.5% and by genotype ( GT ) based on ITT and treatment completion, respectively, was 91% and 92% for GT 1, 100% and 100% for GT 2, 91% and 97% for GT 3, 64% and 95% for GT 4, 87% and 87% for GT 6 and 79% and 91% for GT untested. Patients with cirrhosis had SVR 12 of 85% vs 93% for noncirrhosis ( P < 0.001) ( RR 2.1, 95% CI 1.4‐3.1, P = 0.0002). Patients with GT 1 and GT 3 treated with sofosbuvir/ribavirin ( SR ) had 88% and 89% SVR 12, respectively, but those GT 6 treated with sofosbuvir/ledipasvir ( SL ) had only 77.6% SVR 12. Multivariate analysis showed absence of cirrhosis was associated with higher SVR 12 ( OR 2.0, 95% CI 1.3‐3.1, P = 0.002). In conclusion, patients with GT 1 and GT 3 with/without cirrhosis had surprisingly high efficacy using SR , suggesting that Asians may respond better to some DAA s. However, poor GT 6 response to SL suggests this regimen is suboptimal for this genotype.