High sustained virologic response rates of sofosbuvir-based regimens in Chinese patients with HCV genotype 3a infection
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RESEARCH
Open Access
High sustained virologic response rates of sofosbuvir-based regimens in Chinese patients with HCV genotype 3a infection in a real-world setting Qunying Han†, Xiude Fan†, Xiaoyun Wang, Ye Wang, Huan Deng, Xiaoge Zhang, Kun Zhang, Na Li and Zhengwen Liu*
Abstract Background: Patients with hepatitis C virus (HCV) genotype 3 infection remain a difficult-to-cure population. This study evaluated the efficacy and safety of sofosbuvir-based regimen in genotype 3 patients in a real-world setting. Methods: HCV genotype 3a-infected adults with compensated liver disease were treated with sofosbuvir (SOF)/ velpatasvir (VEL) or SOF/daclatasvir (DCV) with or without ribavirin (RBV) for 12 or 24 weeks, respectively. Efficacy was measured by sustained virologic response at post-treatment week 12 (SVR12). Adverse events were evaluated throughout the treatment and follow-up course. Results: A total of 41 genotype 3a-infected patients were included. Of them, 10 patients (24%) had cirrhosis, 3 (7%) had renal impairment, and 2 (5%) failed previous treatment. Nine patients (22%) were treated with SOF/VEL and 32 (78%) with SOF/DCV with or without RBV. SVR 12 was achieved in 100% (9/9) of patients treated with SOF/VEL for 12 weeks and in 97% (31/32) of those treated with SOF/DCV for 12 or 24 weeks. RBV addition and extension of treatment duration did not improve the SVR of SOF/DCV (RR: 1.04; P = 0.99 and RR: 1.09; P = 0.375, respectively). Ten patients with cirrhosis, 1 on hemodialysis and 2 with treatment-experience achieved SVR12. One treatment-naïve non-cirrhotic patient on hemodialysis treated with SOF/DCV for 24 weeks relapsed at week 8 post-treatment. No serious adverse events and relevant laboratory abnormalities were observed. Conclusion: SOF/VEL and SOF/DCV are highly efficacious and well tolerated in genotype 3a-infected patients with or without cirrhosis. RBV coadministration and extension of SOF/DCV treatment appear to add no improvement for efficacy. Keywords: Hepatitis C, Genotype 3, Cirrhosis, Renal impairment, Treatment
Background Hepatitis C virus (HCV) infection is a major cause of liver cirrhosis, hepatocellular carcinoma (HCC), liver transplantation, and liver-related death worldwide [1]. It is estimated that the total global HCV prevalence is 2.5% and 177.5 million adults are infected by HCV [2]. The prevalence of HCV in China is not precisely known * Correspondence: [email protected] † Qunying Han and Xiude Fan contributed equally to this work. Department of Infectious Diseases, First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an 710061, Shaanxi Province, People’s Republic of China
owing to the absence of large population-based studies. A national survey conducted in 1992 showed that the HCV infection rate was 3.20% in general population in China [3]. A review published in 2015 showed that the HCV prevalence in the general population was 1.6% in mainland China and 1.8–5.5% in Taiwan [4]. There are seven major HCV genotypes (HCV 1–7) including numero
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