Genotype 1 and 3 Response to Velpatasvir and Sofosbuvir in Chronic Hepatitis C in the Kashmiri Population: An Observational Study

Abstract

Our data is one of the earliest study from the Indian subcontinent on Velpatasvir/Sofosbuvir (VEL/SOF) combination in chronic hepatitis C (CHC). The primary end point was to evaluate sustained virologic response (SVR) 12in CHC-infected patients and to determine its effect in patients with hepatitis C virus-related cirrhosis. The secondary end point was to observe any adverse events related to treatment. All patients with CHCwere randomized into two groups: noncirrhotic and cirrhotic. The combination of VEL/SOF was given as recommended. One hundred patients with CHC infection treated with the VEL/SOF regimen were evaluated. A total of 79 (79%) of 100 patients were noncirrhotic, and 21 (21%) were cirrhotic. We achieved SVR12 in 99 (99%) of 100 patients. Among cirrhotics, the mean serum bilirubin (mg/dl), albumin (g/dl), and plateletcount (×10³/μL) improved from baseline 1.82±0.87, 3.22±0.69, and 80.19±46.03 to 1.74±0.87, 3.48±0.72, and 85.05±42.50, respectively, at SVR12 (P-value>0.05). Mean serum alanine aminotransferase (ALT) (U/L) improved from baseline 71.28±59.17 to 35.38±17.39at SVR12 (P-value<0.024). Baseline mean liver stiffness measurement (LSM) in cirrhotic patients was 28.24±10.87kPa, which decreased to 24.04±9.33kPaat SVR12 (P-value, 0.02). The baseline Model for End-StageLiver Disease (MELD) score was 13.47±3.66, which decreased to 12.33±5.46at SVR12 (P-value, 0.28). The Child-Turcotte-Pugh score improved by 1 point in 33.33% (7/21) patients and 2 points in 9.52% (2/21) patients, and in the majority, that is, 38.09% (8/21), the score remained as it is. A single daily dose of the tablet SOF/VEL combination is safe and effective in all types of CHC. There was a significant improvement in the mean transaminase level and LSM at SVR12. And the MELD score improved by 1 point at SVR12 among cirrhotics.