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Hepatology International
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Open Access 21-01-2024 | Hepatitis C | Original Article

An algorithm for simplified hepatitis C virus treatment with non-specialist care based on nation-wide data from Taiwan

Authors: Ming-Lung Yu, Chi‐Ming Tai, Lein-Ray Mo, Hsing-Tao Kuo, Chung-Feng Huang, Kuo-Chih Tseng, Ching-Chu Lo, Ming-Jong Bair, Szu-Jen Wang, Jee-Fu Huang, Ming-Lun Yeh, Chun-Ting Chen, Ming-Chang Tsai, Chien-Wei Huang, Pei-Lun Lee, Tzeng-Hue Yang, Yi-Hsiang Huang, Lee-Won Chong, Chien-Lin Chen, Chi-Chieh Yang, Chao-Hung Hung, Sheng‐Shun Yang, Pin-Nan Cheng, Tsai-Yuan Hsieh, Jui-Ting Hu, Wen-Chih Wu, Chien-Yu Cheng, Guei-Ying Chen, Guo-Xiong Zhou, Wei-Lun Tsai, Chien-Neng Kao, Chih-Lang Lin, Chia-Chi Wang, Ta-Ya Lin, Chih‐Lin Lin, Wei-Wen Su, Tzong-Hsi Lee, Te-Sheng Chang, Chun-Jen Liu, Chia-Yen Dai, Chi-Yi Chen, Jia-Horng Kao, Han-Chieh Lin, Wan-Long Chuang, Cheng-Yuan Peng

Published in: Hepatology International | Issue 2/2024

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Abstract

Background

Both European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (AASLD-IDSA) guidelines recommend simplified hepatitis C virus (HCV) treatment with pan-genotypic sofosbuvir/velpatasvir or glecaprevir/pibrentasvir for eligible patients. This observational study used real-world data to assess these regimens’ safety in eligible patients and develop an algorithm to identify patients suitable for simplified treatment by non-specialists.

Methods

7,677 HCV-infected patients from Taiwan Hepatitis C Registry (TACR) who received at least one dose of sofosbuvir/velpatasvir or glecaprevir/pibrentasvir, and fulfilled the EASL/AASLD-IDSA criteria for simplified treatment were analyzed. Multivariate analysis was conducted on patient characteristics and safety data.

Results

Overall, 92.8% (7,128/7,677) of patients achieved sustained virological response and only 1.9% (146/7,677) experienced Grades 2–4 laboratory abnormalities in key liver function parameters (alanine aminotransferase, aspartate aminotransferase, and total bilirubin), with only 18 patients (0.23%) experiencing Grades 3–4 abnormalities. Age > 70 years old, presence of hepatocellular carcinoma, total bilirubin > 1.2 mg/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, and Fibrosis-4 > 3.25 were associated with higher risks of Grades 2–4 abnormalities. Patients with any of these had an odds of 4.53 times than that of those without in developing Grades 2–4 abnormalities (p < 0.01).

Conclusions

Real-world data from Taiwan confirmed that simplified HCV treatment for eligible patients with pan-genotypic regimens is effective and well tolerated. The TACR algorithm, developed based on this study’s results, can further identify patients who can be safely managed by non-specialist care.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
An algorithm for simplified hepatitis C virus treatment with non-specialist care based on nation-wide data from Taiwan
Authors
Ming-Lung Yu
Chi‐Ming Tai
Lein-Ray Mo
Hsing-Tao Kuo
Chung-Feng Huang
Kuo-Chih Tseng
Ching-Chu Lo
Ming-Jong Bair
Szu-Jen Wang
Jee-Fu Huang
Ming-Lun Yeh
Chun-Ting Chen
Ming-Chang Tsai
Chien-Wei Huang
Pei-Lun Lee
Tzeng-Hue Yang
Yi-Hsiang Huang
Lee-Won Chong
Chien-Lin Chen
Chi-Chieh Yang
Chao-Hung Hung
Sheng‐Shun Yang
Pin-Nan Cheng
Tsai-Yuan Hsieh
Jui-Ting Hu
Wen-Chih Wu
Chien-Yu Cheng
Guei-Ying Chen
Guo-Xiong Zhou
Wei-Lun Tsai
Chien-Neng Kao
Chih-Lang Lin
Chia-Chi Wang
Ta-Ya Lin
Chih‐Lin Lin
Wei-Wen Su
Tzong-Hsi Lee
Te-Sheng Chang
Chun-Jen Liu
Chia-Yen Dai
Chi-Yi Chen
Jia-Horng Kao
Han-Chieh Lin
Wan-Long Chuang
Cheng-Yuan Peng
Publication date
21-01-2024
Publisher
Springer India
Published in
Hepatology International / Issue 2/2024
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-023-10609-7

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