Objectives: To assess the effectiveness and safety of
interferon-free direct-acting
antiviral (DAA)
therapy for patients with concomitant hepatitis C virus (HCV)
infection and
rheumatic diseases (RDs), including
rheumatoid arthritis (RA).Methods: This was a single-center observational case-series study conducted in Japan from 2014 to 2018. The primary endpoint was the sustained virological response (SVR) rate 24 weeks after the end of
therapy (EoT24). We also evaluated hepatological and rheumatological outcomes and adverse events.Results: Of the 2314 patients with RDs, 18 received DAA
therapy (RA = 11, other RDs = 7). The SVR rate for the initial DAA
therapy was 89% (16/18). The remaining two achieved SVR with secondary DAA
therapy. Along with HCV elimination, hepatological parameters improved significantly from baseline to EoT24. During the study period, no patients newly developed
cirrhosis or HCC after HCV elimination. Several patients showed improvement in RDs activity. In RA patients, the simplified disease activity index decreased significantly from baseline to EoT24 (median [interquartile range]: 11.53 [5.14-14.89] vs. 4.06 [2.08-9.05], respectively). On-treatment adverse events were minimal, while two patients experienced
tuberculosis reactivation after EoT.Conclusion: DAA
therapy was effective and safe, providing hepatological and rheumatological benefits in HCV-infected patients with RDs. Immune reconstitution following HCV elimination should be noted.