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Factors associated with treatment failure of direct-acting antivirals for chronic hepatitis C: A real-world nationwide hepatitis C virus registry programme in Taiwan.
Chen, Chi-Yi; Huang, Chung-Feng; Cheng, Pin-Nan; Tseng, Kuo-Chih; Lo, Ching-Chu; Kuo, Hsing-Tao; Huang, Yi-Hsiang; Tai, Chi-Ming; Peng, Cheng-Yuan; Bair, Ming-Jong; Chen, Chien-Hung; Yeh, Ming-Lun; Lin, Chih-Lang; Lin, Chun-Yen; Lee, Pei-Lun; Chong, Lee-Won; Hung, Chao-Hung; Huang, Jee-Fu; Yang, Chi-Chieh; Hu, Jui-Ting; Lin, Chih-Wen; Chen, Chun-Ting; Wang, Chia-Chi; Su, Wei-Wen; Hsieh, Tsai-Yuan; Lin, Chih-Lin; Tsai, Wei-Lun; Lee, Tzong-Hsi; Chen, Guei-Ying; Wang, Szu-Jen; Chang, Chun-Chao; Mo, Lein-Ray; Yang, Sheng-Shun; Wu, Wen-Chih; Huang, Chia-Sheng; Hsiung, Chou-Kwok; Kao, Chien-Neng; Tsai, Pei-Chien; Liu, Chen-Hua; Lee, Mei-Hsuan; Liu, Chun-Jen; Dai, Chia-Yen; Kao, Jia-Horng; Chuang, Wan-Long; Lin, Han-Chieh; Yu, Ming-Lung.
Afiliação
  • Chen CY; Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan.
  • Huang CF; Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Cheng PN; School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Cancer Research and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Tseng KC; Division of Gastroenterology and Hepatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
  • Lo CC; Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
  • Kuo HT; School of Medicine, Tzuchi University, Hualien, Taiwan.
  • Huang YH; Division of Gastroenterology, Department of Internal Medicine, St. Martin De Porres Hospital, Chiayi, Taiwan.
  • Tai CM; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
  • Peng CY; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital.
  • Bair MJ; Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
  • Chen CH; Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
  • Yeh ML; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
  • Lin CL; Center for Digestive Medicine, Department of Internal Medicine, School of Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.
  • Lin CY; Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung, Taiwan.
  • Lee PL; Mackay Medical College, New Taipei City, Taiwan.
  • Chong LW; Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Hung CH; School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Cancer Research and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Huang JF; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Yang CC; Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
  • Hu JT; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.
  • Lin CW; Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Chen CT; Liouying Division of Gastroenterology and Hepatology, Department of Internal medicine, Chi Mei Medical Center, Tainan, Taiwan.
  • Wang CC; Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
  • Su WW; School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
  • Hsieh TY; Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Lin CL; Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Puzi, Taiwan.
  • Tsai WL; School of Medicine and Hepatitis Research Center, College of Medicine, and Center for Cancer Research and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Lee TH; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
  • Chen GY; Department of Gastroenterology, Division of Internal Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan.
  • Wang SJ; Liver Center, Cathay General Hospital, Taipei, Taiwan.
  • Chang CC; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
  • Mo LR; Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, Kaohsiung, Taiwan.
  • Yang SS; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Taipei, Taiwan.
  • Wu WC; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Huang CS; School of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.
  • Hsiung CK; Department of Gastroenterology and Hepatology, Changhua Christian Hospital, Changhua, Taiwan.
  • Kao CN; Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • Tsai PC; Department of Gastroenterology, Renai branch, Taipei City Hospital, Taipei, Taiwan.
  • Liu CH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
  • Lee MH; Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
  • Liu CJ; Penghu Hospital, Ministry of Health and Welfare, Taipei, Taiwan.
  • Dai CY; Division of Gastroenterology, Department of Internal Medicine, Yuan's General Hospital, Kaohsiung, Taiwan.
  • Kao JH; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
  • Chuang WL; Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
  • Lin HC; Division of Gastroenterology, Tainan Municipal Hospital, Tainan, Taiwan.
  • Yu ML; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Liver Int ; 41(6): 1265-1277, 2021 06.
Article em En | MEDLINE | ID: mdl-33655714
ABSTRACT
BACKGROUND/

AIMS:

Direct-acting antivirals (DAAs) are highly effective in treating chronic hepatitis C virus (HCV)-infected patients. The real-world treatment outcome in Taiwanese patients on a nationwide basis is elusive.

METHODS:

The Taiwan HCV Registry (TACR) programme is a nationwide registry platform including 48 study sites, which is organized and supervised by the Taiwan Association for the Study of the Liver. The primary endpoint was sustained virological response (SVR12, undetectable HCV RNA 12 weeks after end-of-treatment).

RESULTS:

A total of 13 951 registered patients with SVR12 data available were analysed (mean age, 63.0 years; female, 55.9%; HCV genotype-1 [GT1], 57.9%; cirrhosis, 38.4%; preexisting hepatocellular carcinoma [HCC], 10.6%; and hepatitis B virus coinfection, 7.7%). The overall SVR12 rate was 98.3%, with 98.7%, 98.0%, 98.4% and 97.4% in treatment-naïve noncirrhotic, treatment-naïve cirrhotic, treatment-experienced noncirrhotic and treatment-experienced cirrhotic patients, respectively. The SVR12 rate was > 95% across all subgroups except treatment-experienced cirrhotic patients who received sofosbuvir/ribavirin (88.7%), treatment-naïve noncirrhotic patients (94.8%) and treatment-experienced cirrhotic (94.8%) patients who received daclatasvir/asunaprevir. The most important factor associated with treatment failure was DAA adherence < 60% ( adjusted odds ratio [aOR]/95% confidence interval [CI] 117.1/52.4-261.3, P < .001), followed by GT3/GT2 (aOR/CI 5.78/2.25-14.9, P = .0003 and aOR/CI 1.55/1.05-2.29, P = .03, compared with GT1), active hepatocellular carcinoma (aOR/CI 4.29/2.57-7.16, P < .001), the use of sofosbuvir/ribavirin (aOR/CI 2.51/1.67-3.77, P < .001) and daclatasvir/asunaprevir (aOR/CI 3.29/1.94-5.58, P < .001), decompensated liver cirrhosis (aOR/CI 2.50/1.20-5.22, P = .02) and high HCV viral loads (aOR/CI 2.16/1.57-2.97, P < .001).

CONCLUSIONS:

DAAs are highly effective in treating Taiwanese HCV patients in the real-world setting. Maintaining DAA adherence and selecting highly efficacious regimens are keys to ensure treatment success.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hepatite C / Carcinoma Hepatocelular / Hepatite C Crônica / Neoplasias Hepáticas Tipo de estudo: Risk_factors_studies Limite: Female / Humans / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hepatite C / Carcinoma Hepatocelular / Hepatite C Crônica / Neoplasias Hepáticas Tipo de estudo: Risk_factors_studies Limite: Female / Humans / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article