Clinical characteristics and antiviral therapy in patients infected with hepatitis C virus in the interferon -free era

INTRODUCTION The highly effective and safe interferon (IFN)-free options were a breakthrough in the treatment of patients infected with hepatitis C virus (HCV). OBJECTIVES The current analysis was designed to evaluate changes in the patient profile and antiviral treatment characteristics over time. PATIENTS AND METHODS The study population consisted of 963 consecutive HCV -infected patients who started IFN-free regimens between July 2015 and December 2020 in the Department of Infectious Diseases in Kielce, Poland. The analysis was carried out for 5 time intervals. RESULTS The studied group was sex-balanced, with the median (interquartile range) age changing from 58 (44.8-63) in 2015-2016 to 43 (35-61) in 2020. The proportion of patients with comorbidities decreased over the years. The rate of treatment-naive individuals increased from 40.9% in 2015-2016 to 91% in 2020, while the percentage of patients with liver cirrhosis decreased from 51.1% in 2015-2016 to 13.3% in 2020. Genotype-specific regimens dominated in the years 2015-2017, while pangenotypic options gained an advantage in 2019 and reached 91% in 2020. Overall effectiveness achieved 98.4% in the per-protocol analysis and was comparable over the years with lower efficacy among patients with liver cirrhosis and those infected with genotype 3. The therapy was well-tolerated, and the safety profile improved over time. CONCLUSIONS The median age of HCV -infected patients decreased over the years. They were less bur-dened with comorbidities and comedications, more likely to be treatment-naive, and had less advanced liver disease. The genotype-specific regimens, predominantly used at the beginning of the IFN-free era, were superseded by the pangenotypic regimens.