Factors associated with treatment failure of direct-acting antivirals for chronic hepatitis C: A real-world nationwide hepatitis C virus registry programme in Taiwan

被引：42

作者：

Chen, Chi-Yi ^{[1
]}

Huang, Chung-Feng ^{[2
,3
,4
,5
,6
,7
]}

Cheng, Pin-Nan ^{[8
]}

Tseng, Kuo-Chih ^{[9
,10
]}

Lo, Ching-Chu ^{[11
]}

Kuo, Hsing-Tao ^{[12
]}

Huang, Yi-Hsiang ^{[13
,14
]}

Tai, Chi-Ming ^{[15
,16
]}

Peng, Cheng-Yuan ^{[17
]}

Bair, Ming-Jong ^{[18
,19
]}

Chen, Chien-Hung ^{[20
]}

Yeh, Ming-Lun ^{[4
,5
,6
,7
,21
]}

Lin, Chih-Lang ^{[22
]}

Lin, Chun-Yen ^{[23
,24
]}

Lee, Pei-Lun ^{[25
]}

Chong, Lee-Won ^{[26
,27
]}

Hung, Chao-Hung ^{[20
,28
]}

Huang, Jee-Fu ^{[4
,5
,6
,7
,29
]}

Yang, Chi-Chieh ^{[30
]}

Hu, Jui-Ting ^{[31
]}

Lin, Chih-Wen ^{[16
,32
]}

Chen, Chun-Ting ^{[33
,34
]}

Wang, Chia-Chi ^{[35
]}

Su, Wei-Wen ^{[36
]}

Hsieh, Tsai-Yuan ^{[34
]}

Lin, Chih-Lin ^{[37
]}

Tsai, Wei-Lun ^{[38
]}

Lee, Tzong-Hsi ^{[39
]}

Chen, Guei-Ying ^{[40
]}

Wang, Szu-Jen ^{[41
]}

Chang, Chun-Chao ^{[42
]}

Mo, Lein-Ray ^{[43
]}

Yang, Sheng-Shun ^{[44
]}

Wu, Wen-Chih ^{[45
]}

Huang, Chia-Sheng ^{[46
]}

Hsiung, Chou-Kwok ^{[47
]}

Kao, Chien-Neng ^{[48
]}

Tsai, Pei-Chien ^{[2
,3
]}

Liu, Chen-Hua ^{[49
,50
]}

Lee, Mei-Hsuan ^{[51
]}

Liu, Chun-Jen ^{[49
,50
]}

Dai, Chia-Yen ^{[2
,3
,4
,5
,6
,7
]}

Kao, Jia-Horng ^{[49
,50
]}

Chuang, Wan-Long ^{[2
,3
,4
,5
,6
,7
]}

Lin, Han-Chieh ^{[13
,14
]}

Yu, Ming-Lung ^{[2
,3
,4
,5
,6
,7
]}

机构：

[1] Chiayi Christian Hosp, Div Gastroenterol & Hepatol, Dept Med, Ditmanson Med Fdn, Chiayi, Taiwan

[2] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Hepatobiliary Div, Dept Internal Med, Kaohsiung, Taiwan

[3] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Hepatitis Ctr, Kaohsiung, Taiwan

[4] Kaohsiung Med Univ, Sch Med, Kaohsiung, Taiwan

[5] Kaohsiung Med Univ, Hepatitis Res Ctr, Coll Med, Kaohsiung, Taiwan

[6] Kaohsiung Med Univ, Ctr Canc Res, Kaohsiung, Taiwan

[7] Kaohsiung Med Univ, Ctr Liquid Biopsy & Cohort Res, Kaohsiung, Taiwan

[8] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Div Gastroenterol & Hepatol, Dept Internal Med,Coll Med, Tainan, Taiwan

[9] Dalin Tzu Chi Hosp, Dept Internal Med, Buddhist Tzu Chi Med Fdn, Chiayi, Taiwan

[10] Tzuchi Univ, Sch Med, Hualien, Taiwan

[11] St Martin Porres Hosp, Div Gastroenterol, Dept Internal Med, Chiayi, Taiwan

[12] Chi Mei Med Ctr, Div Gastroenterol & Hepatol, Dept Internal Med, Tainan, Taiwan

[13] Taipei Vet Gen Hosp, Div Gastroenterol & Hepatol, Dept Med, Taipei, Taiwan

[14] Natl Yang Ming Univ, Sch Med, Inst Clin Med, Taipei, Taiwan

[15] E Da Hosp, Dept Internal Med, Kaohsiung, Taiwan

[16] I Shou Univ, Coll Med, Sch Med, Kaohsiung, Taiwan

[17] China Med Univ, China Med Univ Hosp, Sch Med, Dept Internal Med,Ctr Digest Med, Taichung, Taiwan

[18] Taitung Mackay Mem Hosp, Dept Internal Med, Div Gastroenterol, Taitung, Taiwan

[19] Mackay Med Coll, New Taipei, Taiwan

[20] Chang Gung Univ, Kaohsiung Chang Gung Mem Hosp, Div Hepatogastroenterol, Coll Med,Dept Internal Med, Taoyuan, Taiwan

[21] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Kaohsiung Municipal Siaogang Hosp, Dept Internal Med, Kaohsiung, Taiwan

[22] Keelung Chang Gung Mem Hosp, Dept Gastroenterol & Hepatol, Keelung, Taiwan

[23] Chang Gung Mem Hosp, Linkou Branch, Dept Gastroenterol & Hepatol, Taoyuan, Taiwan

[24] Chang Gung Univ, Grad Inst Biomed Sci, Coll Med, Taoyuan, Taiwan

[25] Chi Mei Med Ctr, Liouying Div Gastroenterol & Hepatol, Dept Internal Med, Tainan, Taiwan

[26] Shin Kong Wu Ho Mem Hosp, Dept Internal Med, Div Hepatol & Gastroenterol, Taipei, Taiwan

[27] Fu Jen Catholic Univ, Sch Med, New Taipei, Taiwan

[28] ChiaYi Chang Gung Mem Hosp, Dept Internal Med, Div Hepatogastroenterol, Puzi, Chiayi, Taiwan

[29] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Kaohsiung Municipal Ta Tung Hosp, Dept Internal Med, Kaohsiung, Taiwan

[30] Show Chwan Mem Hosp, Div Internal Med, Dept Gastroenterol, Changhua, Taiwan

[31] Cathay Gen Hosp, Liver Ctr, Taipei, Taiwan

[32] E Da Dachang Hosp, Div Gastroenterol & Hepatol, Kaohsiung, Taiwan

[33] Tri Serv Gen Hosp, Dept Internal Med, Natl Def Med Ctr, Div Gastroenterol,Penghu Branch, Taipei, Taiwan

[34] Tri Serv Gen Hosp, Dept Internal Med, Natl Def Med Ctr, Div Gastroenterol, Taipei, Taiwan

[35] Tzu Chi Univ, Taipei Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Sch Med, Hualien, Taiwan

[36] Changhua Christian Hosp, Dept Gastroenterol & Hepatol, Changhua, Taiwan

[37] Taipei City Hosp, Renai branch, Dept Gastroenterol, Taipei, Taiwan

[38] Kaohsiung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol & Hepatol, Kaohsiung, Taiwan

[39] Far Eastern Mem Hosp, Div Gastroenterol & Hepatol, New Taipei, Taiwan

[40] Penghu Hosp, Minist Hlth & Welf, Taipei, Taiwan

[41] Yuans Gen Hosp, Dept Internal Med, Div Gastroenterol, Kaohsiung, Taiwan

[42] Taipei Med Univ Hosp, Dept Internal Med, Div Gastroenterol & Hepatol, Taipei, Taiwan

[43] Tainan Municipal Hosp, Div Gastroenterol, Tainan, Taiwan

[44] Taichung Vet Gen Hosp, Dept Internal Med, Div Gastroenterol & Hepatol, Taichung, Taiwan

[45] Wu Wen Chih Clin, Kaohsiung, Taiwan

[46] Yang Ming Hosp, Chiayi, Taiwan

[47] Chou Kwok Hsiung Clin, Magong, Penghu, Taiwan

[48] Natl Taiwan Univ Hosp, Hsin Chu Branch, Hsinchu, Taiwan

[49] Natl Taiwan Univ Hosp, Hepatitis Res Ctr, Taipei, Taiwan

[50] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan

来源：

LIVER INTERNATIONAL | 2021年 / 41卷 / 06期

关键词：

CHC; DAA; HCV; real world; registry; Taiwan;

D O I：

10.1111/liv.14849

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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-naive noncirrhotic, treatment-naive 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-naive 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.

引用

页码：1265 / 1277

页数：13

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