OBJECTIVES: The objective of this study is to evaluate the persistence on treatment of patients on direct-acting antivirals (DAA) therapy for hepatitis C in a Portuguese University Hospital (CHUC).

METHODS: This was an observational study where hospital pharmacy dispensing data were collected over the period Jan/2015-May/2017. Persistence was defined as remaining in therapy and not discontinuing (end of treatment). Crude survival estimates were obtained by Kaplan-Meier method. The risk of HCV treatment discontinuation was estimated by a Cox proportional hazard model. Adherence was a second exploratory endpoint calculated by the pill count approach.

RESULTS: A total of 626 patients were included: mean(SD) age 49.9(10.9) years and 74.4% male. Genotype 1 (72.4%) was the most frequent, 67.4% of patients were treatment naïve and 38.8% metavir F1. Ledipasvir/sofosbuvir was used in 83.2% of the cases. Planned treatment duration was: 12 weeks (69.0%); 24 weeks (29.1%). For these two major subgroups, 68.3% and 63.2% were treatment naïve and 8.1% and 64.8% were metavir F4, respectively. An estimated 8.9% (95% CI = [6.0%:11.7%]) and 16.5% (95% CI = [10.6%:22.0%]) of patients ended treatment before 12 and 24 weeks planned treatment duration, respectively. Men (hazard ratio of discontinuation = 0.77, 95%CI = [0.61:0.97]) and non-cirrhotic patients (HR = 0.70, 95%CI = [0.49:1.0]) were more likely to persist on treatment. Adherence to DAA treatment of 95% or higher was observed in 98% of the 12 weeks and 24 weeks subgroups, respectively.

CONCLUSIONS: Real-world data confirms very high persistence and adherence rates to DAA for the treatment of hepatitis C.