Gut Liver.
2017 Jul;11(4):543-550. 10.5009/gnl16530.
Final Report of Unmet Needs of Interferon-Based Therapy for Chronic Hepatitis C in Korea: Basis for Moving into the Direct-Acting Antiviral Era
- Affiliations
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- 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. jsh@snubh.org
- 2Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
- 3Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
- 4Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 5Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
- 6Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
- 7Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
- KMID: 2412235
- DOI: http://doi.org/10.5009/gnl16530
Abstract
- BACKGROUND/AIMS
To evaluate the era of direct acting antivirals (DAAs), we must understand the treatment patterns and outcomes of interferon-based therapy for hepatitis C virus (HCV) infection. We aimed to elucidate the treatment rate, factors affecting treatment decisions, and efficacy of interferon-based therapy in a real-world setting.
METHODS
This nationwide cohort study included 1,191 newly diagnosed patients with chronic HCV infection at seven tertiary hospitals in South Korea. Subjects were followed retrospectively until March 2015, which was just before the approval of DAA therapy.
RESULTS
In total, 48.2% and 49.3% of the patients had HCV genotypes 1 and 2, respectively. Interferon-based therapy was initiated in 541 patients (45.4%). The major reasons for no treatment included ineligibility (18.9%), concern about adverse events (22.3%), cost (21.5%), and an age >75 years (19.5%). Interferon-based therapy was discontinued (18.5%) mainly due to adverse events (n=66). The intent-to-treat analysis found that the sustained virologic response (SVR) rate was 58.3% in genotype 1 patients and 74.7% in non-genotype 1 patients.
CONCLUSIONS
Approximately one-third of newly diagnosed HCV patients in South Korea received interferon-based therapy and showed a suboptimal SVR rate. Diagnosis of patients at younger ages and with a less advanced liver status and reducing the DAA therapy cost may fulfill unmet needs.
MeSH Terms
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Adult
Aged
Antiviral Agents/*therapeutic use
Female
Genotype
Health Services Needs and Demand/*statistics & numerical data
Hepacivirus/drug effects/genetics
Hepatitis C, Chronic/*drug therapy
Humans
Intention to Treat Analysis
Interferons/*therapeutic use
Male
Middle Aged
Needs Assessment/*statistics & numerical data
Republic of Korea
Retrospective Studies
Sustained Virologic Response
Antiviral Agents
Interferons
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