Abstract
Hepatis virus C (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC) worldwide. The objective of our study was to examine the effects of the HCV nonstructural protein (NS) 3/4A inhibitor glecaprevir/NS5A inhibitor pibrentasvir on real-world HCV patients in the northern part of Tokyo, Japan. Although 106 patients were consecutively included, a total of 102 HCV-infected patients with chronic hepatitis or compensated cirrhosis, who received 8- or 12-week combination treatment with glecaprevir/pibrentasvir and were followed up to week 12 after the end of treatment were analyzed retrospectively. Only three patients discontinued treatment due to adverse events; however, they achieved a sustained virologic response at 12 weeks (SVR12). Finally, SVR rates were 99.0% (101/102). Only one patient without liver cirrhosis was a treatment relapser who received hepatic resection for HCC approximately two years after commencement of the 8-week combination treatment with glecaprevir/pibrentasvir. After the exclusion of patients with HCV genotype 1b and P32 deletion in the HCV NS5A region, a 12-week combination of glecaprevir/pibrentasvir led to SVR12 in all nine direct-acting antiviral-experienced patients. Glecaprevir/pibrentasvir had a high efficacy and an acceptable safety profile for real-world HCV patients in a single hospital in Japan.
Highlights
Chronic hepatitis C virus (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC), which are life-threatening diseases worldwide [1,2]
The combination of glecaprevir/pibrentasvir could be used for the treatment of HCV-infected patients on dialysis and those with severe renal impairment or for the retreatment of HCV-infected patients with previous direct-acting antivirals (DAAs) treatment failure
We report here the real-world experience with glecaprevir/pibrentasvir from 2 ofthe northern part of Tokyo, Japan, generated from a retrospective study of the effectiveness and safety of an 8- or 12-week course of treatment with glecaprevir/pibrentasvir for HCVinfected patients with chronic hepatitis or compensated cirrhosis in daily clinical practice
Summary
Chronic hepatitis C virus (HCV) infection causes liver cirrhosis and hepatocellular carcinoma (HCC), which are life-threatening diseases worldwide [1,2]. The 12-week combination treatment of direct-acting antivirals (DAAs) has higher eradication rates of HCV (ranging from 95–100%) with fewer adverse events [3,4]. Glecaprevir and pibrentasvir are inhibitors of HCV nonstructural (NS) protein 3/4A protease and NS5A, respectively [7]. These combinations of glecaprevir/pibrentasvir have pangenotypic anti-HCV activity with a high barrier to resistance, primarily biliary excretion and negligible renal excretion [8,9,10]. The combination of glecaprevir/pibrentasvir could be used for the treatment of HCV-infected patients on dialysis and those with severe renal impairment or for the retreatment of HCV-infected patients with previous DAA treatment failure
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