Clinical Outcomes Of Patients With Chronic Hepatitis C After Generic Direct-Acting Antiviral Treatments In Vietnam: A Retrospective Analysis

Objective: To evaluate the outcomes of generic direct-acting antiviral treatments for chronic hepatitis C in Vietnam. Methods: The medical records of 522 patients (median 45 years; Female, 25.3%) with chronic hepatitis C treated at a tertiary hospital in northern Vietnam in 2016 were retrospectively reviewed. Results: Female patients were significantly older than male patients (median 52, IQR 41-59 vs. 43 years, IQR: 39-55; P<0.001). Among 522 patients, 49.4% were infected with hepatitis C virus (HCV) genotype 6, followed by 1a (19.0%), 1b (13.0%), and 3 (5.9%). Co-infection with hepatitis B virus or human immunodeficiency virus was noted in 5.8% and 3.1% of patients, respectively. Patients were treated with ledipasvir/sofosbuvir with or without ribavirin (70.9%), sofosbuvir/pegylated-interferon + ribavirin (13.2%), daclatasvir/ sofosbuvir with or without ribavirin (12.5%), or sofosbuvir/ribavirin (3.4%), and 96.4% (n=503) completed the direct-acting antiviral treatment. No patient discontinued treatment due to adverse event(s). A sustained virologic response 12 weeks after the end of the treatment (SVR12) was evaluated in 62.6% of patients. Overall sustained virologic response 12 weeks after the end of the treatment was 98.7% regardless of HCV genotypes or direct-acting antiviral regimens. The severity of liver stiffness was significantly decreased from 10.2 to 6.3 kilopascals measured by transient elastography by the treatment (P<0.001). Among patients who completed the direct-acting antiviral treatment, 17.7% returned for further follow-ups after SVR12. Conclusions: In Vietnam, the current generic direct-acting antiviral treatment for chronic hepatitis C was effective regardless of HCV genotypes and direct-acting antiviral regimens with the attenuation of liver stiffness. It is feasible to implement direct-acting antiviral treatment to cure chronic hepatitis C patients at any liver fibrosis stages in Vietnam.