Factors Associated with Hepatitis C Treatment Failure: a Regional Case-Control Study in Kazakhstan

Arailym Maikenova 1 2, Alexander V. Nersesov 1 2 * , Aigul Raissova 1 2, Elmira Kuantay 1 2 3, Malika Aznabakiyeva 2, Aisulu Gainutdin 1 2, Nazugum Ashimova 1 2
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1 Department of Gastroenterology, Asfendiyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
2 Institute of Gastroenterology, Hepatology and Metabolism "Interna Clinic", Almaty, Republic of Kazakhstan
3 Hepatological Center of Almaty, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 23, Issue 5, pp. 76-80. https://doi.org/10.23950/jcmk/19688
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Author Contributions: Conceptualization,  A.Ner. and A.M.; methodology, A.M., A.Ner. and A.R.; validation, A.M., A.Ner. and A.R.; formal analysis, A.Ner., A.M. and M.Az.; investigation, A.M., A.Ner., E.K. and M.Az.; resources, A.Ner., A.M., E.K., A.G. and N.A.; data curation, A.M. and M.Az.; writing - original draft preparation, A.M., A.Ner., A.R. and M.Az.; writing - review and editing, A.M., A.Ner., A.R., A.G., N.A. and E.K.; visualization, A.M. and M.Az.; supervision, A.Ner., A.M. and A.R.; project administration, A.M. and A.Ner.; funding acquisition, A.Ner., A.M. All authors have read and agreed to the published version of the manuscript.

Data availability statement: The corresponding author can provide the data supporting the study's conclusions upon request. 

Artificial Intelligence (AI) Disclosure Statement: AI was used for grammar check and literature review.

ABSTRACT

Introduction: Direct-acting antiviral therapy achieves high cure rates in chronic hepatitis C; however, a minority of patients do not achieve a sustained virologic response. The aim of this study was to evaluate clinical, demographic, and virologic factors associated with failure to achieve a sustained virologic response among patients with chronic hepatitis C treated in the Turkestan Region of Kazakhstan.
Methods: We performed a retrospective case-control study of 168 adults treated with direct-acting antivirals between January 2018 and December 2022. The control group comprised 126 patients who achieved a sustained virologic response, and the case group comprised 42 patients without a sustained virologic response. Demographic characteristics, disease duration, treatment duration, adherence, hepatitis C virus genotype, pretreatment alanine aminotransferase level, liver elastography, and fibrosis stage were analyzed.
Results: Patients without a sustained virologic response had higher pretreatment alanine aminotransferase levels (p=0.03), higher liver stiffness values on elastography (p=0.007), and a longer duration of chronic hepatitis C before treatment (p<0.0001). Genotype 3 was more frequent among cases than controls (59.5% vs 24.6%; p<0.0001), and F4 fibrosis was also more common (40.5% vs 10.3%; p<0.0001). Treatment duration greater than 12 weeks (p=0.02) and lower treatment adherence (p<0.0001) were more frequent in the case group. Age, sex, ethnicity, and previous pegylated interferon/ribavirin therapy did not differ significantly between groups.
Conclusion: Failure to achieve a sustained virologic response was associated with greater biochemical activity, more advanced liver fibrosis, longer disease duration, genotype 3 infection, and lower treatment adherence. Adherence represents a potentially modifiable factor that may be addressed through structured follow-up and patient counseling.
Keywords: Hepatitis C, Antiviral Agents, Sustained Virologic Response, Liver Fibrosis, Treatment Adherence

CITATION

Maikenova A, Nersesov AV, Raissova A, Kuantay E, Aznabakiyeva M, Gainutdin A, et al. Factors Associated with Hepatitis C Treatment Failure: a Regional Case-Control Study in Kazakhstan. J CLIN MED KAZ. 2026;23(5):76-80. https://doi.org/10.23950/jcmk/19688

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