Real-world effectiveness of pangenotypic direct-acting antivirals in chronic hepatitis C

The aim of this study was to evaluate virological response, biochemical changes, and treatment tolerability in patients with chronic hepatitis C receiving pangenotypic direct-acting antiviral (DAA) therapy. The study included patients with chronic hepatitis C virus infection followed at a tertiary care center between 2018 and 2023. Data were evaluated retrospectively. Patients who completed pangenotypic DAA treatment and had an available SVR12 (sustained virologic response 12 weeks after treatment completion) result were included in the study. Demographic characteristics, genotype distribution, presence of cirrhosis, previous treatment history, hepatitis C virus RNA results, biochemical parameters, and safety data were analyzed descriptively. Fifty-seven patients were included in the study. The mean age was 44.1 years. Thirty-seven patients were male, and 3 patients had compensated cirrhosis. The most frequently detected genotype was 1b, followed by genotype 3a. SVR12 was obtained in all evaluable patients. No virological breakthrough, relapse, treatment discontinuation, or serious adverse events were observed. During treatment, alanine aminotransferase and total bilirubin levels decreased significantly. Albumin levels, however, increased. In this single-center real-world cohort, pangenotypic DAA treatment was associated with SVR12 in all evaluable patients. Treatment was well tolerated, and early biochemical improvement was achieved. The findings should be interpreted considering the retrospective design of the study and the small subgroup size.