2459 Is Shorter Course of Gleceprevir and Pibrentasvir (MAVYRET) for Hepatitis C Treatment Possible? A Case Series

Abstract

INTRODUCTION: Direct-acting oral antiviral agents (DAA) including a combination of Gleceprevir and Pibrentasvir (Mavyret), among others, is the current standard of care therapy for chronic hepatitis C (HCV) infection. These medications have demonstrated high rates of sustained virological response at 12 weeks post-therapy (SVR12) in all genotypes of HCV. More specifically for Mavyret, multiple clinical trials have demonstrated SVR12 in HCV patients after 8, 12, or 16 weeks of therapy. There is, however, no data to support a shorter therapy course. In this small case series, we report 5 subjects who achieved SVR12 with Mavyret after 2 or 4 weeks of therapy. CASE DESCRIPTION/METHODS: Clinical data from a large cohort of patients treated for HCV was retrospectively reviewed for patients treated from 2015-2019. Data extracted and analyzed included patient demographics, HCV treatment regimen, HCV genotype, HCV RNA levels, fibrosis state and sustained virological response (SVR). DISCUSSION: Results: Among the 5 patients identified there were 4 males and 1 female. In total, 4 patients had genotype 1a and 1 patient had genotype 1b. The single patient with SVR12 after 2 weeks of therapy was genotype 1a. The remaining patients received 4 weeks of therapy. Fibrosis Score ranged from F0 to F1, HCV RNA levels ranged from 83,400-8,420,000 and all patients had a documented history of intravenous drug use (Table 1). Conclusion: In this small case series, we present 5 patients who achieved SVR12 after only 2 or 4 weeks of Mavyret therapy. When considering factors such as the cost of therapy, possible history of substance abuse, and/or poor socioeconomic status, opting for a shorter course of therapy may be beneficial. Further large-scale prospective clinical trials are needed to support these findings.