Sustained virologic response rates in patients with chronic hepatitis C genotype 6 treated with ledipasvir+sofosbuvir or sofosbuvir+velpatasvir
| Autor: | Treta Purohit, Huy N. Trinh, Brian S. Levitt, My Nguyen, Sam Trinh, Eugenie Shieh, Huy Nguyen, Aivien Do, Emily Nguyen, Mindie H. Nguyen, Son T. Do, Khanh K. Nguyen |
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| Rok vydání: | 2018 |
| Předmět: |
Liver Cirrhosis
Male Ledipasvir medicine.medical_specialty Asia Cirrhosis Genotype Sustained Virologic Response Sofosbuvir Hepatitis C virus Hepacivirus medicine.disease_cause Antiviral Agents Heterocyclic Compounds 4 or More Rings Gastroenterology Sofosbuvir/velpatasvir Cohort Studies 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Aged Retrospective Studies Fluorenes Hepatology business.industry Retrospective cohort study Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease Drug Combinations chemistry Cohort Benzimidazoles Female 030211 gastroenterology & hepatology Carbamates Uridine Monophosphate business medicine.drug |
| Zdroj: | Alimentary Pharmacology & Therapeutics. 49:99-106 |
| ISSN: | 0269-2813 |
| DOI: | 10.1111/apt.15043 |
| Popis: | Background: Hepatitis C virus (HCV) genotype 6 (GT 6) is the predominant genotype among certain Asian populations. The availability of newer DAA options is limited in many parts of Asia. Aim: To compare sustained virologic response (SVR-12) rates between ledipasvir and sofosbuvir (LDV+SOF) and velpatasvir+SOF (SOF+VEL) for patients with HCVGT6 infection. Method: Retrospective study of consecutive adult HCVGT6 patients identified via ICD 9 code: 070.5 from United States treatment centers. Treatment was LDV+SOF or SOF+VEL for 8-24 weeks. A 1:1 propensity score matching (PSM) on HCV RNA, cirrhosis, alanine aminotransferase, aspartate aminotransferase, platelets, and fibrosis score was conducted among the treatment-naive HCVGT6 patients to balance groups and isolate treatment effects. Results: After exclusion criteria, 149 patients remained (n = 135 treatment-naive; n = 14 treatment-experienced). The mean age was 63.8 ± 10.2 years, 66.9% male, and 93.9% Vietnamese. In treatment-naive arm, 52.2% LDV+SOF cohort were cirrhotic compared to 11.6% SOF+VEL cohort (P < 0.0001). SVR-12 for LDV+SOF was 96.4% and 100% for the SOF+VEL cohort (P = 0.22). SVR-12 for cirrhotic patients was 95.4% (n = 41/43) for LDV+SOF and 100.0% (n = 5/5) for SOF+VEL (P = 0.62). After PSM (n = 33 per group), LDV+SOF SVR-12 rate was 97.0% compared to SOF+VEL SVR-12 of 100% (P = 0.31). The treatment-experienced group (n = 14), were all treated with LDV+SOF with an SVR-12 of 92.3%. Conclusion: Whether treatment-naive, treatment-experienced, or cirrhotic patients with HCV GT 6 residing in the US had excellent outcomes when treated with SOF+VEL or LDV+SOF. Since LDV+SOF is more readily available globally, our results may provide clinicians with a treatment option when cost and availability limit the treatment choice. |
| Databáze: | OpenAIRE |
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