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

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

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.

Citation

Macken, L., Gelson, W., Priest, M., Abouda, G., Barclay, S., Fraser, A., …Verma, S. (2019). Efficacy of direct‐acting antivirals: UK real‐world data from a well‐characterised predominantly cirrhotic HCV cohort. Journal of Medical Virology, 91(11), 1979-1988. https://doi.org/10.1002/jmv.25552

• Journal Article Type: Article
• Acceptance Date: Jul 15, 2019
• Online Publication Date: Jul 22, 2019
• Publication Date: 2019-11
• Deposit Date: Aug 7, 2019
• Publicly Available Date: Jul 23, 2020
• Journal: Journal of Medical Virology
• Print ISSN: 0146-6615
• Electronic ISSN: 1096-9071
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 91
• Issue: 11
• Pages: 1979-1988
• DOI: https://doi.org/10.1002/jmv.25552
• Keywords: Virology; Infectious Diseases
• Public URL: https://nottingham-repository.worktribe.com/output/2400745
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25552
• Additional Information: This is the peer reviewed version of the following article: Macken, L, Gelson, W, Priest, M, et al. Efficacy of direct‐acting antivirals: UK real world data from a well‐characterised predominantly cirrhotic HCV cohort. J Med Virol. 2019; 1‐ 10, which has been published in final form at https://doi.org/10.1002/jmv.25552. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.