Author information
1Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
2Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA.
3Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
4Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung.
5Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung.
6Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
7Gastroenterology & Hepatology, Changi General Hospital, Singhealth, Singapore.
8Singhealth Duke-NUS Medicine Academic Clinical Program, Singapore.
9Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
10Department of Internal Medicine, Hanyang University, College of Medicine, Seoul, Korea.
11Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Korea.
12Department of Hepatology, The Third People's Hospital of Kunming City, Kunming, Yunnan, China.
13Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
14Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
15Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung.
16Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
17Division of Gastroenterology and Hepatology, Nippon Medical School, Tokyo, Japan.
18Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan.
19Department of Transfusion Medicine and Department of Hepatology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
20San Jose Gastroenterology, San Jose, CA, USA.
21Gastroenterology & Hepatology Department, Clinic Fundeni Institute, Bucharest, Romania.
22Division of Gastroenterology and Hepatology, University of Washington, Seattle, WA, USA.
23Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea.
24Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan.
25Liver Center, Saga University Hospital, Saga, Japan.
26Division of Metabolism and Endocrinology, Saga University Faculty of Medicine, Saga, Japan.
27Division of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Chiba, Japan.
282nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.
29Locomedical General Institute, Locomedical Eguchi Hospital, Saga, Japan.
30Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
31Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
32Department of Gastroenterology and Hepatology, The Second People's Hospital of Tianjin, Tianjin, China.
33Department of Infectious Diseases, Henan Provincial People's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
34Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Tianjin, China.
35Department of Medicine, The University of Hong Kong, Hong Kong, China.
36Department of Hepatology, Zhejiang Provincial People's Hospital Affiliated to Zhejiang University, Hangzhou, Zhejiang, China.
37Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
38Center of liver diseases, Beijing Ditan Hospital Affiliated to Capital Medical University, Beijing, China.
39Division of Gastroenterology and Hepatology, National University Hospital, Singapore.
40Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
41Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
42State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
43Digestive Health Associates of Texas, Dallas, TX, USA.
44Taihaku Avenue Clinic, Fukuoka, Japan.
45Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
46Department of Internal Medicine, Haradoi Hospital, Fukuoka, Japan.
47Hepatology Clinic, Kajiwara Clinic, Kitakyushu, Japan.
48Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea.
49Department of Medicine, Kyushu Central Hospital, Fukuoka, Japan.
50Department of Internal Medicine, Chihaya Hospital, Fukuoka, Japan.
51Department of Internal Medicine, Hanyang University, College of Medicine, Guri Hospital, Guri, Korea.
52Division of Hepatology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
53Departments of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea.
54Department of Medicine, Kitakyushu Municipal Medical Center, Fukuoka, Japan.
55Department of Medicine, Fukuoka City Hospital, Fukuoka, Japan.
56Department of Hepatology, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
57Center for Liver Disease, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan.
58Department of Medicine, Hamanomachi Hospital, Fukuoka, Japan.
59Division of Gastoroentelorogy, Nippon Medcal School Chiba Hokusoh Hospital, Chiba, Japan.
60Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
61Department of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan.
62Department of Hepatology, The First Hospital of Jilin University, Changchun, Jilin, China.
63Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
64Department of Hepatology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.
65Liver Diseases Group, Vall d'Hebron Research Institute, Barcelona, Spain.
66Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
67Liver Unit, Department of Internal Medicine, Hospital Universitari Valle d'Hebron and Universitat Autònoma de Barcelona, Barcelona, Spain.
68State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.
69Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Ji'nan, Shandong, China.
70Department of Gastroenterology and Hepatology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
71Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan.
72School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung.
73Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
Abstract
Background and aims: As practice patterns and hepatitis C virus (HCV) genotypes (GT) vary geographically, a global real-world study from both East and West covering all GTs can help inform practice policy toward the 2030 HCV elimination goal. This study aimed to assess the effectiveness and tolerability of DAA treatment in routine clinical practice in a multinational cohort for patients infected with all HCV GTs, focusing on GT3 and GT6.
Methods: We analyzed the sustained virological response (SVR12) of 15,849 chronic hepatitis C patients from 39 Real-World Evidence from the Asia Liver Consortium for HCV clinical sites in Asia Pacific, North America, and Europe between 07/01/2014-07/01/2021.
Results: The mean age was 62±13 years, with 49.6% male. The demographic breakdown was 91.1% Asian (52.9% Japanese, 25.7% Chinese/Taiwanese, 5.4% Korean, 3.3% Malaysian, and 2.9% Vietnamese), 6.4% White, 1.3% Hispanic/Latino, and 1% Black/African-American. Additionally, 34.8% had cirrhosis, 8.6% had hepatocellular carcinoma (HCC), and 24.9% were treatment-experienced (20.7% with interferon, 4.3% with direct-acting antivirals). The largest group was GT1 (10,246 [64.6%]), followed by GT2 (3,686 [23.2%]), GT3 (1,151 [7.2%]), GT6 (457 [2.8%]), GT4 (47 [0.3%]), GT5 (1 [0.006%]), and untyped GTs (261 [1.6%]). The overall SVR12 was 96.9%, with rates over 95% for GT1/2/3/6 but 91.5% for GT4. SVR12 for GT3 was 95.1% overall, 98.2% for GT3a, and 94.0% for GT3b. SVR12 was 98.3% overall for GT6, lower for patients with cirrhosis and treatment-experienced (TE) (93.8%) but ≥97.5% for treatment-naive patients regardless of cirrhosis status. On multivariable analysis, advanced age, prior treatment failure, cirrhosis, active HCC, and GT3/4 were independent predictors of lower SVR12, while being Asian was a significant predictor of achieving SVR12.
Conclusions: In this diverse multinational real-world cohort of patients with various GTs, the overall cure rate was 96.9%, despite large numbers of patients with cirrhosis, HCC, TE, and GT3/6. SVR12 for GT3/6 with cirrhosis and TE was lower but still excellent (>91%).a