Findings from a large Asian chronic hepatitis C real-life study

Seng Gee Lim, Wah Wah Phyo, Samir R. Shah, Khin Maung Win, Saeed Hamid, Teerha Piratvisuth, Soek Siam Tan, Yock Young Dan, Yin Mei Lee, Taufique Ahmed, Wei Lyn Yang, Kok Pun Chen, Mrunal Kamat, Manav Wadhawan, Kaushal Madan, Rajiv Mehta, Akash Shukla, Prashant Dhore, Chundamannil E. Eapen, Priya AbrahamSatyendra Tyagi, Abraham Koshy, Aung Hlaing Bwa, Wasim Jafri, Shahab Abid, Fakhar Ali Qazi Arisar, Tewesak Tanwandee, Thing Phee Yin, Hoi Poh Tee, Rosaida Binti Hj Md Said, Khean Lee Goh, Shiaw Hooi Ho, Rosmawati Mohamed, Norasiah Abu Bakar

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

There is a paucity of information on chronic hepatitis C (CHC) patients treated with direct antiviral agents (DAAs) 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 (SVR12) and virologic failure. SVR12 outcome was based on intention to treat (ITT). Multivariate analysis was used to assess independent risk factors for SVR12 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, SVR12 was 89.5% and by genotype (GT) based on ITT and treatment completion, respectively, was 91% and 92% for GT1, 100% and 100% for GT2, 91% and 97% for GT3, 64% and 95% for GT4, 87% and 87% for GT6 and 79% and 91% for GT untested. Patients with cirrhosis had SVR12 of 85% vs 93% for noncirrhosis (P < 0.001) (RR 2.1, 95% CI 1.4-3.1, P = 0.0002). Patients with GT1 and GT3 treated with sofosbuvir/ribavirin (SR) had 88% and 89% SVR12, respectively, but those GT6 treated with sofosbuvir/ledipasvir (SL) had only 77.6% SVR12. Multivariate analysis showed absence of cirrhosis was associated with higher SVR12 (OR 2.0, 95% CI 1.3-3.1, P = 0.002). In conclusion, patients with GT1 and GT3 with/without cirrhosis had surprisingly high efficacy using SR, suggesting that Asians may respond better to some DAAs. However, poor GT6 response to SL suggests this regimen is suboptimal for this genotype.

Original languageEnglish
Pages (from-to)1533-1542
Number of pages10
JournalJournal of Viral Hepatitis
Volume25
Issue number12
DOIs
Publication statusPublished - Dec 2018

Keywords

  • chronic hepatitis C
  • cure
  • genotype
  • sustained virologic response
  • treatment failure
  • virologic failure

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