Sustained virologic response rates in patients with chronic hepatitis C genotype 6 treated with ledipasvir+sofosbuvir or sofosbuvir+velpatasvir. Issue 1 (22nd November 2018)

• Record Type: Journal Article
• Authors: Nguyen, Emily; Trinh, Sam; Trinh, Huy; Nguyen, Huy; Nguyen, Khanh; Do, Aivien; Levitt, Brian; Do, Son; Nguyen, My; Purohit, Treta; Shieh, Eugenie; Nguyen, Mindie H.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 49:Issue 1(2019)
• Page Start: 99
• Page End: 106
• Publication Date: 2018-11-22
• Subjects: cirrhosis -- genotype 6 -- hepatitis C -- LDV+SOF -- SOF+VEL -- sustained virological response; Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.15043
• Languages: English
• ISSNs: 0269-2813

Abstract

Summary: 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‐naïve HCVGT6 patients to balance groups and isolate treatment effects. Results: After exclusion criteria, 149 patients remained (n = 135 treatment‐naïve; n = 14 treatment‐experienced). The mean age was 63.8 ± 10.2 years, 66.9% male, and 93.9% Vietnamese. In treatment‐naïve 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‐naïve, 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.