O-093 : Efficacy of Daclatasvir and Asunaprevir Treatment in Genotype 1b HCV Infected Patients: A Real Life and Multicenter Study

Aims: Combination of daclatasvir (DCV) and asunaprevir (ASV) has been approved in Korea for the treatment of genotype 1b (GT1b) hepatitis C virus (HCV) infected patients. The efficacy in virologic response, improvement of liver function and non-invasive fibrosis marker in liver cirrhosis (LC) were investigated. Methods: All HCV GT1b patients who were treated with DCV and ASV for at least 4 weeks from August 2015 to January 2017, were retrospectively enrolled. Virologic response was measured at 4 weeks (rapid virologic response, RVR), at 24 weeks (end of treatment response, ETR), and at 12 weeks after the end of treatment (sustained virologic response, SVR12). Liver function, aspartate transaminase to platelet ratio index (APRI), FIB-4 index, and fibrosis index (FI) were compared between before and after treatment (SVR12). Results: Patients with GT1b patients (n=474) were examined for resistance associated variants (RAVs). Sixty-seven patients had RAV. A total of 290 RAV-negative patients were treated with DCV and ASV for at least 4 weeks. Baseline characteristics were obtained: age (54±11 years), gender (male: 50.3%), LC (29.0%), treatment-naive (74.8%), ALT (58.5±49.2 IU/L), HCV RNA (1,915,001±4,969,456 IU/mL). RVR (255/277, 92.1%), ETR (190/195, 97.4%), and SVR (146/152, 96.1%) rates were obtained. SVR rates were not significantly different between non-LC (102/104, 98.1%) and LC patients (44/48, 91.7%) (p=0.080). SVR rates were not significantly different between treatment- naive (103/106, 97.2%) and treatment-experienced patients (43/46, 93.5%) (p=0.368). In LC patients (n=48), there were significant changes of albumin (3.8±0.8 to 4.0±0.5 g/dL, p=0.036), platelet count (109.6±52.6 to 120.3±58.5 x103/mm3, p=0.004), APRI (2.6±3.1 to 0.8±0.6, p=0.001), FIB-4 (7.6±6.5 to 2.9±1.6, p<0.001), and FI (3.1±1.1 to 2.9±1.2, p=0.058) after treatment. Conclusions: DCV and ASV treatment for HCV GT1b infected Korean subjects without RAV achieved high SVR rates. In addition, improvement of liver function and non-invasive fibrosis marker were noted in patients with LC.