D0509 - Delayed Clinical Follow Is Not Associated With Lower SVR Rates in an HCV-Infected Cohort in Mumbai, India

Justin P. Canakis, DO¹, Ameer Halim, MD², Sita Kottilil, ³, Ameer Abutaleb, MD², Mrunal M. Kamat, ⁴, Samir Shah, MD, DM^5
1George Washington University, Washington, DC; ²University of Maryland Medical Center, Baltimore, MD; ³Yale University School of Medicine, New Haven, CT; ⁴Global Hospitals, Mumbai, Mumbai, Maharashtra, India; ⁵Global Hospitals Mumbai, Mumbai, Maharashtra, India

Introduction: Hepatitis C Virus (HCV) has a prevalence of 71 million cases worldwide. Regular follow-up can be challenging for patients in low middle income countries (LMIC) due to lack of access to healthcare facilities and transportation difficulties. Our aim was to determine if delayed vs regular follow up for patients being treated for HCV with direct acting antivirals (DAA) resulted in a difference in sustained virologic response (SVR).

Methods: We conducted a retrospective cohort study of 149 patients in Mumbai, India who had received treatment for Hepatitis C from 2015 to 2021. All patients had confirmed HCV by PCR and were treated with direct acting antivirals (DAA) approved by the FDA equivalent in India. Patients were asked to present for follow up 12 weeks after end of treatment for SVR12 (sustained virologic response) testing.

Results: 149 patients were included. 81 followed up on time (54%) and 68 did not (46%). The mean age at treatment in both groups was similar (51 vs 52, p = 0.29) while male/female distribution showed a significant difference (40% vs 54% male, 60% vs 46% female, p = 0.027). The most common genotype in the cohort was genotype 3 (52% vs 49%) and the second most common was genotype 1 (32% vs 20%). There was not a significant difference in genotypes between both groups (p = 1.0). History of hyperlipidemia (p = 0.12), thyroid disease (p = 0.20), and CKD (p = 0.16) did not show significant difference across both groups. On the other hand, diabetes (p = 0.026) and HTN (p < 0.01) were more prevalent in those who had delayed follow up. There was no significant difference in prior treatment experience between the two groups (p = 0.13). Change in AST and ALT from the initiation of treatment until SVR also did not show significant difference across both groups (p = 0.58, 0.38). Patients with advanced liver disease were more commonly seen in the group which did not have on-time follow up (p < 0.01). SVR was seen more in the group which did not follow up on time (94% vs 79%, p < 0.01).

Discussion: The likelihood of SVR was not impeded by delayed follow-up compared to regular follow-up in this cohort of infected patients. Further research is needed to determine if this is generalizable across different genotypes and geographic locations.



Disclosures:


Justin P. Canakis, DO¹, Ameer Halim, MD², Sita Kottilil, ³, Ameer Abutaleb, MD², Mrunal M. Kamat, ⁴, Samir Shah, MD, DM⁵. D0509 - Delayed Clinical Follow Is Not Associated With Lower SVR Rates in an HCV-Infected Cohort in Mumbai, India, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.