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 1 a(19.0%),1 b(13.0%),and 3(5.9%).Coinfection 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 directacting 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.