Background and importance The new direct acting antivirals (DAAs), indicated in chronic hepatitis C (HCV), show a sustained virological response at 12 weeks (SVR12) >90% in clinical trials, with worse results in patients with genotype 3.
Aim and objectives To analyse the effectiveness of the new DAAs in a real cohort of HCV patients during 2018, and establish if there are differences between genotypes.
Material and methods This was a retrospective observational study including all patients treated with DAAs in 2018. The variables collected were: age, sex, HCV/HIV coinfection, genotype (G), degree of fibrosis (F), previous treatments, basal viral load (BVL), treatment duration, viral load at 12 weeks post-treatment, adherence and adverse effects (AEs). Effectiveness was evaluated according to SVR12.
Results Ninety-one patients (57.1% men) received treatment with DAAs, with a mean age of 55.6±10.4 years; 20 (22%) were coinfected with HIV, and 55 (60,4%) had BVL >800 000 UI/mL. The genotype distribution was: 29 (31.9%) G1a, 28 (30.8%) G1b, 1 (1.1%) G2, 15 (16.5%) G3 and 18 (19.8%) G4. Degree of fibrosis: 27 F0–F1, 16 F1, 10 F2, 15 F3, 2 F3–F4 and 14 F4; 7 (7.7%) patients were without data (WD). There were 75 (82.4%) naive patients; 6 had received treatment with DAAs (2 with two different lines).
Treatment distribution was: 36 (39.6%) glecaprevir/pibrentasvir, 28 for 8 weeks and 8 for 12 weeks; 29 (31.9%) elbasvir/grazoprevir, 28 for 12 weeks and 1 for 16 weeks; 23 (25.3%) sofosbuvir/velpatasvir for 2 weeks, 2 with ribavirin; 1 (1.1%) ledipasvir/sofosbuvir for 8 weeks; 2 (2.2%) sofosbuvir/velpatasvir/voxilaprevir for 12 weeks, both after relapse to two previous lines with DAAs.
The response observed was: glecaprevir/pibrentasvir 32 SVR12, 3 WD and 1 treatment suspension because of the patient‘s poor clinical condition; elbasvir/grazoprevir 26 SVR12 and 3 WD; sofosbuvir/velpatasvir 17 SVR12, 3 WD, 1 died (sepsis) and 2 virological failure (VF) (both G3, 1 F3, 1 F4, 1 relapsed to DAAs); ledipasvir/sofosbuvir: 1 SRV12; sofosbuvir/velpatasvir/voxilaprevir 2 SRV12. Of the total evaluable responses (n=80), 78 (97.5%) SRV12 and 2 (2.5%) VF were observed.
Conclusion and relevance Our data confirm the effectiveness of the new DAAs, with SVR12 >95%, and are consistent with clinical trials which show that patients with G3 have the worst SVR12 rates.
References and/or acknowledgements No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.