Early Viral Kinetics in Patients with Chronic Hepatitis C Treated with Direct-Acting Antivirals

Objectives: We aimed to determine parameters affecting viral kinetics among the first case series of chronic hepatitis C treated with direct-acting oral antiviral drugs in a tertiary university hospital and thus contribute to real-life data on direct-acting antiviral (DAA) treatments. Materials and Methods: This is a prospective observational study that enrolled patients with chronic hepatitis C infection who were followed up between 2017 and 2019 and administered DAA treatment. Hepatitis C virus (HCV)-RNA (real-time polymerase chain reaction) was detected in the plasma samples of the patients before treatment (day 0) and on the 3rd and 7th days of treatment. Test results below 35 IU/mL were considered negative. Results: The paritaprevir/ritonavir/ombitasvir/dasabuvir regimen was administered to 21 (44%) patients, sofosbuvir-based regimens to 28 (54%) patients, and glecaprevir-pibrentasvir treatment to 1 (2%) patient. HCV-RNA was detected to be negative significantly earlier in younger patients (p=0.005). The median disease duration was 7 years (range: 2-10), and viral clearance was obtained significantly earlier (p=0.038) in patients with a longer disease duration. The median initial viral load was 3,079,870 (range: 650,925-5,973,029) IU/mL, and no statistically significant correlation was found between the time to negative viral load and initial viral load (p=0.208). Conclusion: Patients of younger ages and those with a history of longer disease durations became negative earlier, within the first days of treatment. No significant correlation was detected between the initial viral load and early viral kinetics.