Efficacy of pangenotypic direct‐acting antivirals in treating hepatitis C virus infection: A comparative analysis of urban and rural settings

Abstract This study compared the treatment outcomes of patients with hepatitis C virus (HCV) treated with direct‐acting antivirals (DAAs) at Taipei Medical University Hospital and Fangliao General Hospital in Pingtung, focusing on the efficacy of oral pangenotypic DAAs, including Epclusa (sofosbuvir/velpatasvir) and Maviret (glecaprevir/pibrentasvir), in improving various clinical indicators and reducing liver fibrosis in patients with hepatitis C. This study collected data from 583 patients with hepatitis C who underwent treatment with pangenotypic DAAs at Taipei Medical University Hospital and Fangliao General Hospital between 2017 and 2023. After exclusion of those lost to follow‐up or with incomplete information, 482 patients were enrolled for statistical analysis. This study compared the improvements in liver function and liver fibrosis indicators after treatment in both settings. A total of 482 patients with chronic HCV were enrolled: 239 from Pingtung and 243 from Taipei. Compared with the patients in Taipei, the average age of the patients in Fangliao was older, and the average degree of liver fibrosis, as indicated by the Fibrosis‐4 (FIB‐4) index, was higher. Liver fibrosis reduction was more pronounced among the patients in Fangliao than those in Taipei, with improvements of 0.5 in Taipei and 0.7815 in Fangliao ( p < .05). Furthermore, the reduction in liver fibrosis among patients using Epclusa was greater than that among patients using Maviret. However, in multivariate linear regression analysis, neither geographical location nor drug type was statistically significant. Age and pretreatment FIB‐4 index were the primary factors affecting posttreatment improvement. This study underscores that treatment with DAAs improves liver function and reduces liver fibrosis in both urban and rural settings. Patients with hepatitis C who are older and have a higher FIB‐4 index should be given priority for DAA treatment.