Epidemiological characteristics, genotype patterns, and treatment outcomes in chronic hepatitis C patients receiving direct-acting antivirals: a cohort study from Istanbul, Türkiye

We aimed to evaluate the real-world effectiveness and safety of direct-acting antiviral agents (DAAs) in patients with chronic hepatitis C (CHC) and to describe genotype distribution. Patients diagnosed with CHC and treated with DAAs between June 2016 and January 2023 were included in this single-center, retrospective observational cohort study. Among the 402 patients initially evaluated, 233 patients with available sustained virological response at 12 weeks (SVR12) data were included in the final analysis. The median age was 53 years (range, 18–92), and 50.2% of patients were female; 208 patients (89.3%) were treatment-naïve. Among patients with a single HCV genotype, genotype 1b was the most prevalent. Genotype 3 infection was more frequently observed among individuals with a history of incarceration, alcohol use disorder, and intravenous drug use, whereas genotype 4 was more common among Syrian patients. Overall rates of rapid virological response, end-of-treatment virological response, and SVR12 were 95.6% (n = 195/204), 99.5% (n = 221/222), and 99.6% (n = 232/233), respectively. Compared with baseline, serum albumin concentrations (p = 0.030), WBC counts (p = 0.021), and PLT counts (p < 0.001) increased significantly, while serum AST (p < 0.001), ALT (p < 0.001), ALP (p = 0.011), and GGT (p < 0.001) enzyme activity levels showed significant decreases. Total bilirubin and AFP concentrations also declined significantly (both p < 0.001). Adverse events were infrequent and mild, with fatigue and pruritus (each n = 7, 3.0%) being the most commonly reported. No treatment discontinuation or treatment-related mortality was observed during follow-up. In this real-world cohort, DAA therapy was highly effective and well tolerated, including among vulnerable populations. The observed genotype distribution was consistent with previously reported national data and local population characteristics. These findings likely reflect migration-related epidemiological patterns and changing population dynamics rather than causal relationships. Targeted screening strategies and equitable access to DAAs remain essential for effective HCV control and reduction of its public health burden.