The Efficacy of Direct-Acting Antiviral Treatment for Hepatitis C in Challenging Cases within a Healthcare System

Direct-acting antivirals (DAAs) have transformed the treatment of chronic hepatitis C (HCV), however there is a dearth of empirical evidence about their efficacy in vulnerable demographics, such as those without insurance. The purpose of our research is to examine the effectiveness of direct-acting antiviral therapy for hepatitis C in difficult cases within a medical system. Patients in the Department of Gastroenterology at St. Vincent's University Hospital in Dublin, Ireland, who begin DAA-based treatment for chronic HCV, as well as all HCV-infected patients beginning DAA-based, IFN-free therapy between April 2024 and June 2024, are studied prospectively. Therapeutic termination, therapeutic recurrence or lack of surveillance were supplementary endpoints, whereas sustained virologic response (SVR) was the main objective. Descriptive parameter assessments between the different groups were carried out. Considering both univariate and multivariate logistic regression models, SVR determinants were found. P < 0.05 was considered statistically significant for multivariate analysis. With SPSS Version 25, statistical analysis was carried out. The median age of individuals undergoing therapy was 59 years old, and the majority (58%) were male, according to the baseline data. There was cirrhosis in around half of the patients (51%). Genotypes 1a (60%) and 1b (19%) were the most prevalent HCV genotypes. Treatment regimens that were most frequently used were LDV + SOF ± RBV (69%), SOF + RBV (10%), and SMV + SOF ± RBV (9%). Higher SVR rates were correlated with female sex. The SVR rates for those with and without insurance were same. The most substantial unfavorable predictor of SVR after modification was cirrhosis. In underfunded, hard-to-treat the general population, DAA-based therapy can produce positive results in healthcare facilities with limited resources.