Effectiveness of chronic hepatitis C treatment with direct-acting antivirals in the Public Health System in Brazil

Iandra Holzmann, Cristiane V. Tovo, Roseline Minmé, Mônica P. Leal, Michele P. Kliemann, Camila Ubirajara, Amanda A. Aquino, Bruna Araujo, Paulo R.L. Almeida

Chronic hepatitis C virus (HCV) infection is one of the major causes of cirrhosis, hepatocellular carcinoma and liver transplantation. Treatment using direct-acting antivirals (DAA) has revolutionized the treatment of HCV, increasing long-term prognosis after cure. The goal of the present study was to evaluate the effectiveness of DAA in HCV treatment in a Public Health System in southern Brazil. A retrospective study evaluated all patients with chronic HCV infection who underwent treatment at one center of the Public Health Department of the State of Rio Grande do Sul - Brazil, according to the Brazilian Clinical Protocol and Therapeutic Guidelines. The effectiveness was assessed in terms sustained virological response (SVR) 12 weeks after the end of treatment. A total of 1002 patients who were treated for chronic HCV infection were evaluated. The mean age was 58.6 years, 557 patients (55.6%) were male and 550 (54.9%) were cirrhotic. Overall SVR was observed in 936 (93.4%) patients. There was a difference in SVR rate varied according to sex, 91.6% in men and 95.7% in women (p = 0.009), length of treatment in genotype 1, 92.7% with 12 weeks and 99.1 with 24 weeks (p = 0.040), and genotype, 94.7% in genotype 1, 91.7% in genotype 2, and 91.4% in genotype 3 (p = 0.047). The treatment of chronic HCV infection for genotypes 1, 2 or 3 with the therapeutic regimens established by the Brazilian guidelines showed high rates of SVR, even in cirrhotic patients.