Hepatitis C virus cure with direct acting antivirals: Clinical, economic, societal and patient value for China

Table 1 Clinical efficacy of direct acting antiviral in major empirical studies in China

Study Information	Study regimen	SVR12	Ref.
Pivotal phase 3; TN patients; GT1b	DCV + ASV	Non-cirrhotic: 92%	[45]
		Cirrhotic: 94%
Pivotal phase 3b; TN and TE patients; GT1, 2, 3, 6	SOF + RBV ± PEG-IFN	Non-cirrhotic GT1/2/3/6: 96%/93%/97%/100%	[49]
		Cirrhotic GT1/2/3/6: 84%/88%/88%/50%
		(GT6 with cirrhosis: n = 2)
Pivotal phase 3b; TN and TE patients; GT1b	LDV/SOF	100%	[46]
Pivotal phase 3; TN and TE patients; GT1b, 2, 3, 6	SOF/VEL	GT1b/2/3/6: 100%/100%/83%/100% (Subgroup SVR12: GT3a: 91%; GT3b non-cirrhotic/cirrhotic: 96%/50%)	[50]
Pivotal phase 3; TN patients; GT1, 6	EBR/GZR	GT1/6: 97%/80% (GT1: 140/146 patients were GT1b; GT6: n = 5)	[48]
Pivotal phase 3; TN and TE patients; GT1b	O/P/r + D	99%–100%	[47]
Prospective cohort; TE; GT1b	SOF + DCV	100% (SVR24)	[53]
	LDV/SOF	100% (SVR24)
	PEG-IFN + RBV	28% (SVR24)
Real-world study; TN and TE HCV patients with DCC	SOF-containing regimens	90%; with significant improvement in hepatic function among SVR patients	[54]

ASV: Asunaprevir; DCC: Decompensated cirrhosis; DCV: Daclatasvir; EBR: Elbasvir; GT: Genotype; GZR: Grazoprevir; HCV: Hepatitis C virus; LDV: Ledipasvir; O/P/r + D: Ombitasvir/paritaprevir/ritonavir plus dasabuvir; PEG-IFN: Pegylated-interferon; RBV: Ribavirin; SOF: Sofosbuvir; SVR: Sustained virologic response; TE: Treatment experienced; TN: Treatment naïve; VEL: Velpatasvir.

Table 2 Model predicted long-term clinical outcomes of using direct acting antivirals in China

Study Information	Regimens compared	Predicted reduction in liver sequelae relative to PR therapy
		DCC	HCC	Liver transplant	Liver-related death
Simulating 10000 Chinese CHC patients over a lifetime horizon;	GLE/PIB[57]	-95%	-90%	-95%	-92%
	SOF/VEL[56,57]	-96%	-91%	-96%	-93%
	DCV + ASV[56]	-51%	-48%	-51%	-49%
	O/P/r + D[56]	-59%	-55%	-59%	-57%
	EBR/GZR[56]	-59%	-55%	-59%	-57%
GT1b, 2, 3, 6

ASV: Asunaprevir; CHC: Chronic hepatitis C; DCC: Decompensated cirrhosis; DCV: Daclatasvir; EBR: Elbasvir; GT: Genotype; GZR: Grazoprevir; HCC: Hepatocellular carcinoma; O/P/r + D: Ombitasvir/paritaprevir/ritonavir plus dasabuvir; PR: Pegylated-interferon plus ribavirin; RBV: Ribavirin; SOF: Sofosbuvir; VEL: Velpatasvir.