Trends and efficacy of interferon-free anti–hepatitis C virus therapy in the region of high prevalence of elderly patients, cirrhosis, and hepatocellular carcinoma: A real-world, nationwide, multicenter study of 10 688 patients in Japan

Hidenori Toyoda, Masanori Atsukawa, Haruki Uojima, Akito Nozaki, Hideyuki Tamai, Koichi Takaguchi, Shinichi Fujioka, Makoto Nakamuta, Toshifumi Tada, Satoshi Yasuda, Makoto Chuma, Tomonori Senoh, Akemi Tsutsui, Naoki Yamashita, Atsushi Hiraoka, Kojiro Michitaka, Toshihide Shima, Takehiro Akahane, Ei Itobayashi, Tsunamasa WatanabeHiroki Ikeda, Etsuko Iio, Shinya Fukunishi, Toru Asano, Yoshihiko Tachi, Tadashi Ikegami, Kunihiko Tsuji, Hiroshi Abe, Keizo Kato, Shigeru Mikami, Hironao Okubo, Noritomo Shimada, Toru Ishikawa, Yoshihiro Matsumoto, Norio Itokawa, Taeang Arai, Akihito Tsubota, Katsuhiko Iwakiri, Yasuhito Tanaka, Takashi Kumada

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background. We investigated changes in patient characteristics, rate of sustained virologic response (SVR), and factors associated with SVR after anti-hepatitis C virus (HCV) therapy with direct-acting antiviral (DAA) regimens in real-world practice in Japan, where patients with HCV are characterized by older age and high prevalence of cirrhosis and hepatocellular carcinoma (HCC). Methods. Changes in patient characteristics and SVR rates were evaluated from medical records among 10 688 patients who started interferon (IFN)-free DAA therapy between September 2014 and June 2018 in a nationwide, multicenter study. Factors associated with failure of SVR were analyzed. In particular, effects of cirrhosis or history of HCC on SVR were assessed by exact matching. Results. Patient age was becoming younger and baseline liver fibrosis was becoming milder over time. Overall SVR rate was 95.4%. The SVR rates increased over time in patients without a history of IFN-free DAA therapy. Multivariate analysis revealed that cirrhosis was unfavorably associated with achievement of SVR in both patients with genotype 1 (odds ratio, 1.68; 95% confidence interval [CI], 1.27–2.21) and genotype 2 (odds ratio, 1.69; 95% CI, 1.01–2.78). Comparisons after exact matching showed that the SVR rate was significantly lower in patients with cirrhosis than without it, whereas patients with and without a history of HCC had similar SVR rates. Conclusions. Background characteristics of patients who undergo IFN-free DAA therapy are changing in Japan. Patients without a history of IFN-free DAA therapy have high SVR rates. Exact matching confirmed that cirrhosis significantly influences the achievement of SVR in real-world settings.

Original languageEnglish
JournalOpen Forum Infectious Diseases
Volume6
Issue number5
DOIs
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Trends and efficacy of interferon-free anti–hepatitis C virus therapy in the region of high prevalence of elderly patients, cirrhosis, and hepatocellular carcinoma: A real-world, nationwide, multicenter study of 10 688 patients in Japan'. Together they form a unique fingerprint.

Cite this