Miotto N, et al. - This study was designed to assess risk factors for premature treatment discontinuation among patients with hepatitis C and advanced fibrosis with advanced fibrosis treated with interferon (IFN)-free direct antiviral agents (DAA)-based therapy. As per findings, researchers suggested considering older age and advanced liver disease in relation to treatment interruption. Identification of risk factors associated with treatment discontinuation seemed crucial to recognize patients who should be followed up closely during treatment.

Methods

• All patients with chronic hepatitis C virus infection and advanced liver fibrosis who received treatment with IFN-free DAA therapy at a university hospital were included from December 2015 through June 2016.
• Data was prospectively collected from medical records using standardized questionnaires; evaluation of data was performed using Epi Info 7.1.2.0.
• Treatment interruption and associated factors were assessed primarily.

Results

• This study included 214 patients; 180 patients were treated with sofosbuvir (SOF)+daclatasvir±ribavirin (RBV), 31 received SOF+simeprevir±RBV, and three were treated with SOF+RBV.
• 19 patients (8.9%) discontinued treatment; cirrhotic decompensation was the main reason for treatment discontinuation[8 (42.1%)].
• Among patients with Child B or C cirrhosis (31), premature treatment interruption was observed in 10 (32.2%).
• Univariate analysis suggested that the risk factors for treatment discontinuation were older age (P=0.0252), higher comorbidity index (P=0.0078), higher model for end-stage liver disease (P<0.0001), higher fibrosis index based on the 4 factores (P=0.0122), and lower hemoglobin (P=0.0185) at baseline.
• In multivariate analysis, older age (odds ratio: 1.1, 95% confidence interval: 1.02–1.19) and higher model for end-stage liver disease (odds ratio: 1.27, 95% confidence interval: 1.03–1.56) were associated with premature treatment interruption.