@article{b5ffa0e3b51a403795771d7a2a97e10d,
title = "Factors associated with treatment failure of direct-acting antivirals for chronic hepatitis C: A real-world nationwide hepatitis C virus registry programme in Taiwan",
abstract = "Background/aims: Direct-acting antivirals (DAAs) are highly effective in treating chronic hepatitis C virus (HCV)-infected patients. The real-world treatment outcome in Taiwanese patients on a nationwide basis is elusive. Methods: The Taiwan HCV Registry (TACR) programme is a nationwide registry platform including 48 study sites, which is organized and supervised by the Taiwan Association for the Study of the Liver. The primary endpoint was sustained virological response (SVR12, undetectable HCV RNA 12 weeks after end-of-treatment). Results: A total of 13 951 registered patients with SVR12 data available were analysed (mean age, 63.0 years; female, 55.9%; HCV genotype-1 [GT1], 57.9%; cirrhosis, 38.4%; preexisting hepatocellular carcinoma [HCC], 10.6%; and hepatitis B virus coinfection, 7.7%). The overall SVR12 rate was 98.3%, with 98.7%, 98.0%, 98.4% and 97.4% in treatment-na{\"i}ve noncirrhotic, treatment-na{\"i}ve cirrhotic, treatment-experienced noncirrhotic and treatment-experienced cirrhotic patients, respectively. The SVR12 rate was > 95% across all subgroups except treatment-experienced cirrhotic patients who received sofosbuvir/ribavirin (88.7%), treatment-na{\"i}ve noncirrhotic patients (94.8%) and treatment-experienced cirrhotic (94.8%) patients who received daclatasvir/asunaprevir. The most important factor associated with treatment failure was DAA adherence < 60% (adjusted odds ratio [aOR]/95% confidence interval [CI]: 117.1/52.4-261.3, P <.001), followed by GT3/GT2 (aOR/CI: 5.78/2.25-14.9, P =.0003 and aOR/CI: 1.55/1.05-2.29, P =.03, compared with GT1), active hepatocellular carcinoma (aOR/CI: 4.29/2.57-7.16, P <.001), the use of sofosbuvir/ribavirin (aOR/CI: 2.51/1.67-3.77, P <.001) and daclatasvir/asunaprevir (aOR/CI: 3.29/1.94-5.58, P <.001), decompensated liver cirrhosis (aOR/CI: 2.50/1.20-5.22, P =.02) and high HCV viral loads (aOR/CI: 2.16/1.57-2.97, P <.001). Conclusions: DAAs are highly effective in treating Taiwanese HCV patients in the real-world setting. Maintaining DAA adherence and selecting highly efficacious regimens are keys to ensure treatment success.",
author = "Chen, {Chi Yi} and Huang, {Chung Feng} and Cheng, {Pin Nan} and Tseng, {Kuo Chih} and Lo, {Ching Chu} and Kuo, {Hsing Tao} and Huang, {Yi Hsiang} and Tai, {Chi Ming} and Peng, {Cheng Yuan} and Bair, {Ming Jong} and Chen, {Chien Hung} and Yeh, {Ming Lun} and Lin, {Chih Lang} and Lin, {Chun Yen} and Lee, {Pei Lun} and Chong, {Lee Won} and Hung, {Chao Hung} and Huang, {Jee Fu} and Yang, {Chi Chieh} and Hu, {Jui Ting} and Lin, {Chih Wen} and Chen, {Chun Ting} and Wang, {Chia Chi} and Su, {Wei Wen} and Hsieh, {Tsai Yuan} and Lin, {Chih Lin} and Tsai, {Wei Lun} and Lee, {Tzong Hsi} and Chen, {Guei Ying} and Wang, {Szu Jen} and Chang, {Chun Chao} and Mo, {Lein Ray} and Yang, {Sheng Shun} and Wu, {Wen Chih} and Huang, {Chia Sheng} and Hsiung, {Chou Kwok} and Kao, {Chien Neng} and Tsai, {Pei Chien} and Liu, {Chen Hua} and Lee, {Mei Hsuan} and Liu, {Chun Jen} and Dai, {Chia Yen} and Kao, {Jia Horng} and Chuang, {Wan Long} and Lin, {Han Chieh} and Yu, {Ming Lung}",
note = "Funding Information: The study was also supported by grants from Kaohsiung Medical University (MOST 109‐2314‐B‐037‐044) and Kaohsiung Medical University Hospital (KMUH‐DK(整)109005 ~ 1, KMUH‐DK(世)109002, KMUH108‐8R05, KMUH108‐8R09, MOHW109‐TDU‐B‐212‐114006 and MOST 109‐2314‐B‐037‐044). Funding Information: The study was also supported by grants from Kaohsiung Medical University (MOST 109-2314-B-037-044) and Kaohsiung Medical University Hospital (KMUH-DK(整)109005 ~ 1, KMUH-DK(世)109002, KMUH108-8R05, KMUH108-8R09, MOHW109-TDU-B-212-114006 and MOST 109-2314-B-037-044). The authors would like to thank the Taiwan Association for the Study of Liver (TASL), the TASL Foundation and Taiwan Liver Research Foundation for grant support and the TACR study group for data collection. We also thank the Center for Medical informatics and Statistics of Kaohsiung Medical University for providing administrative and funding support. Funding Information: The authors would like to thank the Taiwan Association for the Study of Liver (TASL), the TASL Foundation and Taiwan Liver Research Foundation for grant support and the TACR study group for data collection. We also thank the Center for Medical informatics and Statistics of Kaohsiung Medical University for providing administrative and funding support. Publisher Copyright: {\textcopyright} 2021 The Authors. Liver International published by John Wiley & Sons Ltd.",
year = "2021",
month = jun,
doi = "10.1111/liv.14849",
language = "English",
volume = "41",
pages = "1265--1277",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "6",
}