Comparison of three therapeutic regimens for genotype‐3 hepatitis C virus infection in a large real‐life multicentre cohort. (3rd February 2020)

• Record Type: Journal Article
• Authors: Soria, Alessandro; Fava, Marco; Bernasconi, Davide P.; Lapadula, Giuseppe; Colella, Elisa; Valsecchi, Maria G.; Migliorino, Guglielmo M.; D'Ambrosio, Roberta; Landonio, Simona; Schiavini, Monica; Spinetti, Angiola; Carriero, Canio; Degasperi, Elisabetta; Cologni, Giuliana; Gatti, Federico; Viganò, Paolo; Hasson, Hamid; Uberti‐Foppa, Caterina; Pasulo, Luisa; Baiguera, Chiara; Rossotti, Roberto; Vinci, Maria; Puoti, Massimo; Giorgini, Alessia; Menzaghi, Barbara; Lombardi, Andrea; Pan, Angelo; Aghemo, Alessio; Grossi, Paolo A.; Boldizzoni, Roberto; Colombo, Silvia; Viganò, Mauro; Rumi, Maria G.; Del Poggio, Paolo; Valenti, Luca; Giglio, Omar; De Bona, Anna; d'Arminio Monforte, Antonella; Colombo, Alberto; Spinelli, Ombretta; Pigozzi, Marie G.; Molteni, Chiara; Bonfanti, Paolo; Terreni, Natalia; Perini, Paolo; Capretti, Andrea; Bella, Daniele; Liani, Cecilia; Polo, Silvia; Aimo, Gianpiero; Pagnucco, Layla; Bhoori, Sherrie; Centenaro, Riccardo; Graffeo, Massimo; Ciaccio, Antonio; Dionigi, Elena; Lazzaroni, Sergio; Carderi, Isabella; Di Marco, Mariella; Rizzardini, Giuliano; Noventa, Franco; Lampertico, Pietro; Fagiuoli, Stefano;
• Is Part Of: Liver international. Volume 40:Number 4(2020)
• Page Start: 769
• Page End: 777
• Publication Date: 2020-02-03
• Subjects: daclatasvir -- genotype 3 -- glecaprevir -- Hepatitis C -- pibrentasvir -- ribavirin -- sofosbuvir -- sustained virological response -- velpatasvir; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.14386
• Languages: English
• ISSNs: 1478-3223

Abstract

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. 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. 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 Log10 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. 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 <> genotype.