1. Ledipasvir/sofosbuvir for HCV genotype 1, 2, 4-6 infection: Real-world evidence from a nationwide registry in Taiwan.
- Author
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Lo, Ching-Chu, Huang, Chung-Feng, Cheng, Pin-Nan, Tseng, Kuo-Chih, Chen, Chi-Yi, Kuo, Hsing-Tao, Huang, Yi-Hsiang, Tai, Chi-Ming, Peng, Cheng-Yuan, Bair, Ming-Jong, Chen, Chien-Hung, Yeh, Ming-Lun, Lin, Chih-Lang, Lin, Chun-Yen, Lee, Pei-Lun, Chong, Lee-Won, Hung, Chao-Hung, Chang, Te Sheng, Huang, Jee-Fu, and Yang, Chi-Chieh
- Subjects
CHRONIC hepatitis C ,CHRONIC kidney failure ,SOFOSBUVIR ,GENOTYPES ,CIRRHOSIS of the liver ,HEPATORENAL syndrome ,COMBINATION drug therapy ,HETEROCYCLIC compounds ,ACQUISITION of data ,HEPATITIS viruses ,ANTIVIRAL agents ,HYDROCARBONS ,NUCLEOTIDES ,RIBAVIRIN ,DISEASE complications - Abstract
Background/purpose: The Taiwan Association for the Study of the Liver (TASL) HCV Registry (TACR) is a nationwide registry of chronic hepatitis C patients in Taiwan. This study evaluated antiviral effectiveness of ledipasvir (LDV)/sofosbuvir (SOF) in patients in the TACR.Methods: Patients enrolled in TACR from 2017-2020 treated with LDV/SOF were eligible. The primary outcome was the proportion of patients with sustained virologic response 12 weeks after end of treatment (SVR12).Results: 5644 LDV/SOF ± ribavirin-treated patients were included (mean age: 61.4 years; 54.4% female). Dominant viral genotypes were GT1 (50.8%) and GT2 (39.3%). 1529 (27.1%) patients had liver cirrhosis, including 201 (3.6%) with liver decompensation; 686 (12.2%) had chronic kidney disease. SVR12 was achieved in 98.6% of the overall population and in 98.2% and 98.7% of patients with and without cirrhosis, respectively. SVR12 rates in patients with compensated cirrhosis treated with LDV/SOF without RBV were >98%, regardless of prior treatment experience. SVR12 was 98.6%, 98.4%, 100%, 100%, and 98.7% among those with GT1, GT2, GT4, GT5, and GT6 infections, respectively. Although patient numbers were relatively small, SVR12 rates of 100% were reported in patients infected with HCV GT2, GT5, and GT6 with decompensated cirrhosis and 98% in patients with severely compromised renal function. LDV/SOF adherence ≤60% (P < 0.001) was the most important factor associated with treatment failure. Incidence of adverse events was 15.8%, with fatigue being the most common.Conclusion: LDV/SOF is effective and well tolerated in routine clinical practice in Taiwan. Cure rates were high across patient populations. [ABSTRACT FROM AUTHOR]- Published
- 2022
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