Titre
Real-life experience of chronic hepatitis C treatment in Switzerland: a retrospective analysis.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Moschouri, E.
Auteure/Auteur
Salemme, G.
Auteure/Auteur
Baserga, A.
Auteure/Auteur
Cerny, A.
Auteure/Auteur
Deibel, A.
Auteure/Auteur
Müllhaupt, B.
Auteure/Auteur
Meier, M.A.
Auteure/Auteur
Bernsmeier, C.
Auteure/Auteur
Ongaro, M.
Auteure/Auteur
Negro, F.
Auteure/Auteur
Grosjean, M.
Auteure/Auteur
Clerc, O.
Auteure/Auteur
Künzler-Heule, P.
Auteure/Auteur
Semela, D.
Auteure/Auteur
Hobi, G.
Auteure/Auteur
Stickel, F.
Auteure/Auteur
Mathieu, A.
Auteure/Auteur
Mdawar-Bailly, E.
Auteure/Auteur
Faouzi, M.
Auteure/Auteur
Moradpour, D.
Auteure/Auteur
Fraga, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1424-3997
Statut éditorial
Publié
Date de publication
2024-06-24
Volume
154
Numéro
6
Première page
3698
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
Direct-acting antivirals (DAAs) have revolutionised the management of chronic hepatitis C. We analysed the use of different generations of DAAs over time in Switzerland and investigated factors predictive of treatment failure.
This retrospective study was conducted within the framework of the Swiss Association for the Study of the Liver and the Swiss Hepatitis C Cohort Study; it included all patients with chronic hepatitis C treated with DAAs between January 2015 and December 2019 at eight Swiss referral centres.
A total of 3088 patients were included; 57.3% were male, and the median age was 54 years. Liver cirrhosis was present in 23.9% of the cohort, 87.8% of whom were compensated. The overall sustained virological response (SVR) rate (defined as undetectable HCV RNA at week 12 after the first course of DAA-based treatment) was 96.2%, with an increase over time. The rate of treatment failure dropped from 8.3% in 2015 to 2.5% in 2019. Multivariable analysis revealed that female sex, the use of the latest generation of pangenotypic DAA regimens, Caucasian origin, and genotype (gt) 1 were associated with SVR, whereas the presence of active hepatocellular carcinoma (HCC), gt 3, and increasing liver stiffness were associated with treatment failure. Notably, the presence of active HCC during treatment increased the risk of DAA failure by a factor of almost thirteen.
SVR rates increased over time, and the highest success rates were identified after the introduction of the latest generation of pangenotypic DAA regimens. Active HCC, gt 3 and increasing liver stiffness were associated with DAA failure.
This retrospective study was conducted within the framework of the Swiss Association for the Study of the Liver and the Swiss Hepatitis C Cohort Study; it included all patients with chronic hepatitis C treated with DAAs between January 2015 and December 2019 at eight Swiss referral centres.
A total of 3088 patients were included; 57.3% were male, and the median age was 54 years. Liver cirrhosis was present in 23.9% of the cohort, 87.8% of whom were compensated. The overall sustained virological response (SVR) rate (defined as undetectable HCV RNA at week 12 after the first course of DAA-based treatment) was 96.2%, with an increase over time. The rate of treatment failure dropped from 8.3% in 2015 to 2.5% in 2019. Multivariable analysis revealed that female sex, the use of the latest generation of pangenotypic DAA regimens, Caucasian origin, and genotype (gt) 1 were associated with SVR, whereas the presence of active hepatocellular carcinoma (HCC), gt 3, and increasing liver stiffness were associated with treatment failure. Notably, the presence of active HCC during treatment increased the risk of DAA failure by a factor of almost thirteen.
SVR rates increased over time, and the highest success rates were identified after the introduction of the latest generation of pangenotypic DAA regimens. Active HCC, gt 3 and increasing liver stiffness were associated with DAA failure.
PID Serval
serval:BIB_10FF40A294DD
PMID
Open Access
Oui
Date de création
2024-07-12T11:15:04.226Z
Date de création dans IRIS
2025-05-20T16:44:11Z
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Nom
38980176.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
590 KB
Format
Adobe PDF
PID Serval
serval:BIB_10FF40A294DD.P001
URN
urn:nbn:ch:serval-BIB_10FF40A294DD6
Somme de contrôle
(MD5):7fb38cc81f2524dcde08ac07e286ff50