Retreatment with elbasvir, grazoprevir, sofosbuvir ± ribavirin is effective for GT3 and GT1/4/6 HCV infection after relapse.
Amides
Antiviral Agents
/ therapeutic use
Benzofurans
/ therapeutic use
Carbamates
Cyclopropanes
Drug Therapy, Combination
Female
Hepacivirus
/ genetics
Hepatitis C
/ drug therapy
Humans
Imidazoles
/ therapeutic use
Male
Middle Aged
Quinoxalines
/ therapeutic use
Recurrence
Ribavirin
/ therapeutic use
Salvage Therapy
Sofosbuvir
/ therapeutic use
Sulfonamides
Sustained Virologic Response
hepatitis C
resistance-associated substitution
retreatment
salvage
virological relapse
Journal
Liver international : official journal of the International Association for the Study of the Liver
ISSN: 1478-3231
Titre abrégé: Liver Int
Pays: United States
ID NLM: 101160857
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
03
04
2019
revised:
31
05
2019
accepted:
04
07
2019
pubmed:
30
7
2019
medline:
6
10
2020
entrez:
30
7
2019
Statut:
ppublish
Résumé
Despite highly effective direct-acting antiviral (DAA) therapies for chronic hepatitis C virus (HCV) infection, some patients experience virological relapse. Salvage regimens should include multiple agents to suppress emergence of resistance-associated substitutions (RAS) and minimise treatment failure. The combination of sofosbuvir (SOF) and elbasvir/grazoprevir (ELB/GZR) ±ribavirin (RBV) is an effective retreatment strategy for HCV genotype (GT)1 and 4 infection. We hypothesised that SOF and ELB/GZR (±RBV) would also be an effective salvage regimen for DAA-experienced GT3 patients. We evaluated the efficacy and safety of SOF/ELB/GZR ± RBV in DAA-experienced participants with chronic HCV infection who had prior relapse. Participants were treated at four hospitals between December 2016 and March 2018 for either 12- or 16-weeks. The primary endpoint was sustained virological response at week 12 post-treatment (SVR12) using intention-to-treat analysis. There were 40 participants included in the analysis. The mean age was 53 years, 53% had GT3, 33% had GT1 infection and 63% had cirrhosis. Fifty-eight percent were treated for 12 weeks, 42% were treated for 16 weeks and 90% received RBV. The SVR12 rate was 98% overall, 100% in non-GT3 participants and 95% in GT3 participants. One GT3 cirrhotic participant relapsed. ELB/GZR was stopped at week 6 in one GT3 cirrhotic participant who switched to SOF/velpatasvir/RBV for a further 12 weeks and achieved SVR12. RBV dose reduction was required in two participants. Treatment was otherwise well tolerated. The combination of SOF/ELB/GZR ± RBV is effective and safe for difficult-to-cure patients who relapse after first-line DAA, including those with cirrhosis and GT3 infection.
Substances chimiques
Amides
0
Antiviral Agents
0
Benzofurans
0
Carbamates
0
Cyclopropanes
0
Imidazoles
0
Quinoxalines
0
Sulfonamides
0
Ribavirin
49717AWG6K
grazoprevir
4O2AB118LA
elbasvir
632L571YDK
Sofosbuvir
WJ6CA3ZU8B
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2285-2290Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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