Background Hepatitis C is a serious health problem with a high prevalence rate, and is the leading cause of liver transplantation. The development of well tolerated and highly effective direct acting antivirals (DAAs) for hepatitis C virus (HCV) has dramatically changed the therapeutic landscape.
Purpose To assess the effectiveness of sosbuvir/daclatasvir (SOF+DCV) compared with sofosbuvir/ledipasvir (SOF/LDV) used for the treatment of HCV genotype 3 infection.
Material and methods This was a retrospective and observational study between April 2015 and January 2016. Inclusion criteria: patients with HCV genotype 3 infection treated with either SOF/LDV±ribavirin (RBV) or SOF+DCV during the study period. Exclusion criteria: patients with no data available. Outcomes collected: demographics(age and sex); clinical data(baseline viral load (VL), SVR at week 12 (SVR12), defined as HCV RNA titres <15 IU/mL); METAVIR score(F0–F4); liver transplant; HIV co-infection; and previous treatments for HCV. Data were collected from the medical records of patients.
Results Treatment with SOF/LDV±RBV: 20 patients were included (65% men) with a mean age of 53.05±9.05 years. Patients were treated for 12 weeks. METAVIR score: F4 (cirrhosis) (45%), F3 (35%), F2 (15%) and F1 (5%). 10% of patients were HIV coinfected, 15% had a liver transplant and 30% were pretreated with RBV/peginterferon. 45% of patients had an initial VL >800 000UI/mL. Treatment SOF/LDV: naive-non-cirrhotic patients (n=5) achieving SVR12 60%, naive-cirrhotic (n=5) achieving SVR12 only 40%; pretreated non-cirrhotic (n=3) achieving SVR12 66.66% and 1 pretreated cirrhotic who did not achieve SVR12. Treatment SOF/LDV/RBV: naive-non-cirrhotic (n=3) and naïve-cirrhotic (n=1), all achieved SVR12; pretreated cirrhotic (n=2), only one patient achieved SVR12.
Treatment with SOF+DCV: 20 patients (85% men) were included with a mean age of 53.05±9.05 years. Patients were treated for 12 weeks. METAVIR score: F4 (cirrhosis) 50%, F3 (20%), F2 (20%) and F1 (10%). HIV coinfected patients 45%, pretreated with RBV/peginterferon 25% and 30% had basal VL >800 000UI/mL. All patients (19/20=95%) achieved SVR12 except 1 pretreated cirrhotic patient.
Conclusion Treatment with SOF+DCV seemed to be more effective in our study. This matches the upper SVR12 rate achieved in ALLY-3 for SOF+DCV compared with results obtained in ELECTRON-2 for SOF/LDV in genotype 3, although the sample size and different baseline characteristics of the patients could have influenced these results.
No conflict of interest
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