Real-world Effectiveness and Tolerability of Interferonfree Direct-acting Antiviral for 15,849 Patients with Chronic Hepatitis C:A Multinational Cohort Study  

作　　者：Fanpu Ji Sally Tran Eiichi Ogawa Chung-Feng Huang Takanori Suzuki Yu Jun Wong Hidenori Toyoda Dae Won Jun Liu Li Haruki Uojima Akito Nozaki Makoto Chuma Cheng-Hao Tseng Yao-Chun Hsu Masatoshi Ishigami Takashi Honda Masanori Atsukawa Hiroaki Haga Masaru Enomoto Huy Trinh Carmen Monica Preda Phillip Vutien Charles Landis Dong Hyun Lee Tsunamasa Watanabe Hirokazu Takahashi Hiroshi Abe Akira Asai Yuichiro Eguchi Jie Li Xiaozhong Wang Jia Li Junping Liu Jing Liang Carla Pui-Mei Lam Rui Huang Qing Ye Hongying Pan Jiajie Zhang Dachuan Cai Qi Wang Daniel Q.Huang Grace Wong Vincent Wai-Sun Wong Junyi Li Son Do Norihiro Furusyo Makoto Nakamuta Hideyuki Nomura Eiji Kajiwara Eileen L.Yoon Sang Bong Ahn Koichi Azuma Kazufumi Dohmen Jihyun An Do Seon Song Hyun Chin Cho Akira Kawano Toshimasa Koyanagi Aritsune Ooho Takeaki Satoh Kazuhiro Takahashi Ming-Lun Yeh Pei-Chien Tsai Satoshi Yasuda Yunyu Zhao Yishan Liu Tomomi Okubo Norio Itokawa Mi Jung Jun Toru Ishikawa Koichi Takaguchi Tomonori Senoh Mingyuan Zhang Changqing Zhao Raluca Ioana Alecu Wei Xuan Tay Pooja Devan Joanne Kimiko Liu Ritsuzo Kozuka Elena Vargas-Accarino Ai-Thien Do Mayumi Maeda Wan-Long Chuang Jee-Fu Huang Chia-Yen Dai Ramsey Cheung Maria Buti Junqi Niu Wen Xie Hong Ren Seng Gee Lim Chao Wu Man-Fung Yuen Jia Shang Qiang Zhu Yoshiyuki Ueno Yasuhito Tanaka Jun Hayashi Ming-Lung Yu Mindie H.Nguyen 

机构地区：[1]Department of Infectious Diseases,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi,China [2]Division of Gastroenterology and Hepatology,Department of Medicine,Stanford University Medical Center,Palo Alto,CA,USA [3]Department of General Internal Medicine,Kyushu University Hospital,Fukuoka,Japan [4]Hepatobiliary Division,Department of Internal Medicine,Kaohsiung Medical University Hospital,Kaohsiung [5]Hepatitis Research Center,College of Medicine and Center for Liquid Biopsy and Cohort Research,Kaohsiung Medical University,Kaohsiung [6]Department of Gastroenterology and Metabolism,Nagoya City University Graduate School of Medical Sciences,Nagoya,Japan [7]Gastroenterology&Hepatology,Changi General Hospital,Singhealth,Singapore [8]Singhealth Duke-NUS Medicine Academic Clinical Program,Singapore [9]Department of Gastroenterology,Ogaki Municipal Hospital,Ogaki,Japan [10]Department of Internal Medicine,Hanyang University,College of Medicine,Seoul,Korea [11]Hanyang Institute of Bioscience and Biotechnology,Hanyang University,Seoul,Korea [12]Department of Hepatology,The Third People's Hospital of Kunming City,Kunming,Yunnan,China [13]Department of Gastroenterology,Internal Medicine,Kitasato University School of Medicine,Sagamihara,Japan [14]Gastroenterological Center,Yokohama City University Medical Center,Yokohama,Japan [15]Division of Gastroenterology and Hepatology,Department of Internal Medicine,E-Da Cancer Hospital,Kaohsiung [16]Department of Gastroenterology and Hepatology,Nagoya University Graduate School of Medicine,Nagoya,Japan [17]Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan [18]Department of Gastroenterology,Yamagata University Faculty of Medicine,Yamagata,Japan [19]Department of Transfusion Medicine and Department of Hepatology,Osaka Metropolitan University Graduate School of Medicine,Osaka,Japan [20]San Jose Gastroenterology,San Jose,CA,USA [21]Gastroenterology&Hepatology Department,Clinic Fundeni Institute,Bucharest,Romania [22]Division of Gas

出　　处：《Journal of Clinical and Translational Hepatology》2024年第7期646-658,共13页临床与转化肝病杂志（英文版）

基　　金：partially supported by an investigator-initiated research grant(IN-US-334-4309)from Gilead Sciences to Stanford University.

摘　　要：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/Taiwan residents,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 tretment-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 realworld 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%).

关 键 词：Hepatitis C virus Liver cirrhosis Hepatocellular carcinoma GENOTYPE DAA REAL-C 

分 类 号：R512.63[医药卫生—内科学]