Efficacy of direct-acting antivirals: UK real-world data from a well-characterised predominantly cirrhotic HCV cohort

Lucia Macken, William Gelson, Matthew Priest, George Abouda, Stephen Barclay, Andrew Fraser, Brendan Healey, Will Irving, Sumita Verma

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

Direct-acting antivirals (DAAs) have revolutionised the management of chronic hepatitis C virus (HCV) infection. We describe UK real-world DAA experience. Individuals commencing HCV treatment containing a DAA regimen (Mar 2014-Nov 2016), participating in the National HCV Research UK (HCVRUK) Cohort Study were recruited from 33 UK HCV centers. The data were prospectively entered at sites onto a centralised database. The data were reported as median (Q1-Q3). Of the 1448 treated patients, 1054 (73%) were males, the median age being 54 years (47-60), 900 (62%) being genotype 1 and 455 (31%) genotype 3. The majority, 887 (61%) had cirrhosis, and 590 (41%) were treatment-experienced. DAA regimens utilised: genotype1 sofosbuvir (SOF)/Ledipasvir/±Ribavirin (625/900, 69%) and Ombitasvir/Paritaprevir/Dasabuvir/±RBV (220/900, 24%), and in genotype 3 SOF/Daclatasvir + RBV (256/455, 56%) and SOF/pegylated interferon/RBV (157/455, 35%). Overall, 1321 (91%) achieved sustained virological response (SVR12), genotype 1 vs 3, 93% vs 87%, P <.001. Prior treatment, presence of cirrhosis and treatment regimen did not impact SVR12. Predictors of treatment failure were genotype 3 infection, OR, 2.015 (95% CI: 1.279-3.176, P =.003), and male sex, OR, 1.878 (95% CI: 1.071-3.291, P =.028). Of those with hepatic decompensation at baseline (n = 39), 51% (n = 20) recompensated post-treatment, lower baseline serum creatinine being associated with recompensation (P =.029). There were two liver-related deaths, both having decompensated disease. This real-world UK data, comprising of a predominantly cirrhotic HCV genotype 1/3 cohort, confirms DAA efficacy with an overall 91% SVR12, with 51% recompensating post-treatment. Genotype 3 infection was a predictor of treatment failure.

Original languageEnglish
Pages (from-to)1979-1988
Number of pages10
JournalJournal of Medical Virology
Volume91
Issue number11
Early online date22 Jul 2019
DOIs
Publication statusPublished - Nov 2019

Keywords

  • genotype 1
  • genotype 3
  • hepatic decompensation
  • hepatic recompensation
  • SVR12
  • treatment failure
  • Hepatitis C
  • hepatic recompensation

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology

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