Background Hepatitis C is a serious disease with high prevalence, leading the causes 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 Assessing the effectiveness of sofosbuvir/ledipasvir (SOF/LDV), dasabuvir/paritaprevir/ombitasvir/ritonavir (DSV/PTV+R/OBV) and sofosbuvir/simeprevir (SOF+SIM) used in the treatment of the hepatitis C virus genotype-1 infection.
Material and methods Retrospective and observational study during 2015. Inclusion criteria: patients with HCV genotype-1 infection treated for 12 weeks either with SOF/LDV or SOF+SMV or PTV+R/OBV/DSV during study period. Exclusion criteria: patients with no data available, deaths or without therapeutic adherence. Outcomes collected: demographics: age and sex. Clinical data: basal viral load (BVL), SVR at week 12 (SVR12), defined as HCV RNA titres lower than 15 IU/mL. METAVIR score: F0 to F4. Subgenotype, liver transplant, HIV co-infection, previous treatments for HCV. Data were collected from the medical records of patients.
Results Treatment with SOF/LDV: 39 patients were included (64.1% males) with a mean age of 60.3±9.1 years. Subgenotypic distribution was: 15.4% gt-1, 28.2% gt. 1-A, 56.4% gt. 1-B. According to METAVIR score: F4 to F3 (74.35%), F2 to F1 (25.65%). 17.9% patients were HIV-coinfected and 25.6% were liver transplanted. 51.3% were pretreated with ribavirin/peginterferon and 76.9%% had BVL>than 800,000 UI/ml. All patients (39) achieved SVR12.
Treatment with PTV+R/OBV/DSV: 52 patients (67.32% male) were included with mean age 55.2±10 years. Subgenotypic distribution: 11.5% gt-1, 21.1% gt. 1-A, 67.4% gt. 1-B. Degree of fibrosis: F4 to F3 (75%), F2 to F1 (25%). HIV-coinfected patients 30.8%, and 30.7% pretreated with ribavirin/peginterferon. 57.7% had BVL>800,000 UI/ml. 98% (51/52) patients achieved SVR12.
Treatment with SOF+SMV: 61 patients (59% males) were included, with mean age of 56.3±10 years. Subgenotypic distribution: 23% gt-1, 21.3% gt. 1-A, 55.7% gt. 1-B. METAVIR score: F4 to F3 (88.5%). F2 to F1 (11.5%). 70.5% had BVL>800,000 UI/ml. 16.4% were coinfected, and 65.6% pretreated. 90.2% (55/61) achieved SVR12.
Conclusion The SVR12 rates achieved in this study with the treatments SOF/LDV, SOF/SMV and PTV/OBV/r±RBV match the results obtained in published clinical trials ION–1,2,3; SAPPHIRE 1–2, PEARL 2–3–4, TURQUOISE 2–3 and COSMOS/OPTIMIST, respectively. These results indicate an excellent response to the AADs, and allow us to see a horizon of the eradication of VHC disease.
No conflict of interest
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