Outcomes of and Challenges to Management of Hepatitis C Virus Infection

Background: Treatment of hepatitis C (HCV) infection is becoming more achievable due to increased accessibility to direct-acting antiviral agents (DAAs). Objective: To evaluate the outcomes of the management of HCV-infected patients. Success is defined as the achievement of a sustained virologic response (SVR). Design: A Single-Center Retrospective Study. Setting: Bahrain Defence Force Hospital, Bahrain. Method: Sixty-six patients on DAA therapy for HCV infection were evaluated for SVR achievement, side-effects, and cirrhosis. The characteristics of responders and non-responders to therapy were documented. Result: Sixty-three (95.5%) patients were treated successfully with DAAs. Three were identified as treatment failure, one due to non-compliance, and two cases had advanced cirrhosis. Three patients reported treatment side-effects, although this did not prevent the completion of therapy. Despite treatment, 18 (27%) patients had cirrhosis upon follow-up. Conclusion: Most patients in Bahrain have HCV genotype 1, and the management of these patients has excellent outcomes, the vast majority achieving SVR. A small number of treatment failures were associated with the presence of cirrhosis and non-compliance. Further study, on a national scale, in multiple centers, is required to evaluate the extent of chronic HCV infection.