Background The recent approval of the new direct acting antivirals (DAAs) has extended treatment options in hepatitis C virus (HCV) genotype 1 infected patients with compensated liver disease.
Purpose To evaluate which factors can influence the selection of DAAs in genotype 1 HCV patients in our setting.
Material and methods Retrospective study including genotype 1 HCV patients treated with interferon free DAAs from December 2014 to September 2015. Data collected: demographics, genotype 1 subtype, HIV infection, presence of liver cirrhosis (LC), prior treatment status (naïve or pretreated) and other concomitant drugs. DAAs were classified as follows: sofosbuvir+simeprevir±ribavirin (SOF/SMV); sofosbuvir+daclatasvir±ribavirin (SOF/DCV); sofosbuvir/ledipasvir±ribavirin (SOF/LDV); ombitasvir/paritaprevir/ritonavir+dasabuvir±RBV (OBV/PTV/r/DSV). The χ2 test and the Mann-Whitney U test were used for categorical and quantitative variables, respectively.
Results We included 124 patients: 79 (63.7%) male; mean age 60.8 (±SD 11.5) years; 35 (28.2%) genotype 1a; 26 (21%) HIV/HCV coinfected; 79 (63.7%) LC; 65 (52.4%) naïve; and 56 (45.2%) with polypharmacy (>3 drugs, median value).
DAA regimen selected: 34 (27.4%) SOF/SMV; 14 (11.3%) SOF/DCV; 34 (27.4%) SOF/LDV and 42 (33.9%) OBV/PTV/r/DSV. There were statistically significant differences in the frequency distribution of the different selected DAAs (table 1)
A tendency was observed when comparing different genotype subtypes (p = 0.094) or presence of polypharmacy (p = 0.088).
Conclusion HIV/HCV coinfected and cirrhotic patients were more likely to be treated with SOF/LDV while HCV monoinfected and non-cirrhotic patients with likely to receive OBV/PTV/r/DSV. Pretreated patients were more likely to be treated with SOF/SMV while those naïve with more likely to receive OBV/PTV/r/DSV.
The major potential for drug-drug interactions of OBV/PTV/r/DSV and its lower experience in advanced liver disease and previous triple therapy failure could have influenced these findings.
References and/or Acknowledgements
Pawlotsky JM. EASL Recommendations on Treatment of Hepatitis C 2015. J Hepatol 2015
References and/or AcknowledgementsNo conflict of interest.
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