Barriers to treatment of failed or interferon ineligible patients in the era of DAA: single center study.
BACKGROUND/AIMS
Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs) have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR) rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs.


METHODS
Medical records of patients with positive serum anti-hepatitis C virus (HCV) or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis.


RESULTS
A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16%) of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse) and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems). Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7%) could not be treated with DAA due to financial, social, or cancer-related conditions.


CONCLUSIONS
Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons.
['Seo|Kwang Il|KI|', 'Yun|Byung Chul|BC|', 'Li|Weiquan James|WJ|', 'Lee|Sang Uk|SU|', 'Han|Byung Hoon|BH|', 'Park|Eun Taek|ET|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000914:Antibodies, Viral D000998:Antiviral Agents D005260:Female D005838:Genotype D016174:Hepacivirus D019698:Hepatitis C, Chronic D006801:Humans D016898:Interferon-alpha D008297:Male D008875:Middle Aged D012367:RNA, Viral D012008:Recurrence D012189:Retrospective Studies D055815:Young Adult
Interferons Hepatitis C Direct acting antivirals