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Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort.

Authors :
Soria A
Fava M
Bernasconi DP
Lapadula G
Colella E
Valsecchi MG
Migliorino GM
D'Ambrosio R
Landonio S
Schiavini M
Spinetti A
Carriero C
Degasperi E
Cologni G
Gatti F
Viganò P
Hasson H
Uberti-Foppa C
Pasulo L
Baiguera C
Rossotti R
Vinci M
Puoti M
Giorgini A
Menzaghi B
Lombardi A
Pan A
Aghemo A
Grossi PA
Boldizzoni R
Colombo S
Viganò M
Rumi MG
Del Poggio P
Valenti L
Giglio O
De Bona A
d'Arminio Monforte A
Colombo A
Spinelli O
Pigozzi MG
Molteni C
Bonfanti P
Terreni N
Perini P
Capretti A
Bella D
Liani C
Polo S
Aimo G
Pagnucco L
Bhoori S
Centenaro R
Graffeo M
Ciaccio A
Dionigi E
Lazzaroni S
Carderi I
Di Marco M
Rizzardini G
Noventa F
Lampertico P
Fagiuoli S
Source :
Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2020 Apr; Vol. 40 (4), pp. 769-777. Date of Electronic Publication: 2020 Feb 03.
Publication Year :
2020

Abstract

Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap.<br />Methods: Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression.<br />Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P = .065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P = .007) and lower median pretreatment Log <subscript>10</subscript> HCV-RNA (5.87 vs 6.20, P = .001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12.<br />Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <<difficult-to-treat>> genotype.<br /> (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Details

Language :
English
ISSN :
1478-3231
Volume :
40
Issue :
4
Database :
MEDLINE
Journal :
Liver international : official journal of the International Association for the Study of the Liver
Publication Type :
Academic Journal
Accession number :
31970845
Full Text :
https://doi.org/10.1111/liv.14386