Sofosbuvir-based regimens in the treatment of patients with chronic hepatitis C virus infection: Real-world efficacy in Thailand.

Apichet Sirinawasatien,Thanaya Techasirioangkun,Chen-Hua Liu

doi:10.1371/journal.pone.0229517

Apichet Sirinawasatien, Thanaya Techasirioangkun + Show 1 more

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https://doi.org/10.1371/journal.pone.0229517

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Journal: PloS one	Publication Date: Feb 27, 2020
Citations: 8	License type: CC BY 4.0

Affiliation: Rangsit University, Rajavithi Hospital

Abstract

AimsTo analyze the efficacy and safety of sofosbuvir (SOF)-based regimens in Thai patients with chronic hepatitis C virus infection who had pre-existing significant liver fibrosis.Patients and methodsThis was a retrospective cohort study, conducted between 1 June 2018 and 31 May 2019 at Rajavithi Hospital, Bangkok, Thailand. All patients completed 12 weeks of SOF-based regimens and had follow-up for at least 12 weeks after therapy discontinuation. The primary outcome was sustained virological response (SVR) 12 weeks after the end of therapy.ResultA total of 185 patients were included, with 52, 63 and 70 taking SOF+Ledipasvir (SOF+LDV), SOF+LDV+ribavirin (RBV) and SOF+Pegylated interferon (Peg-IFN)+RBV (SOF+Peg-IFN+RBV) respectively. Genotype (GT) 1 was predominant at 40.0%, followed by GT3 at 37.8%, and GT6 at 22.2%. Overall 95.1% of patients in this study achieved SVR (n = 176/185), and the only factor associated with SVR was HCV genotype (p = 0.001). GT6 patients had lower SVR rates compared to GT1 and GT3 patients (82.9%, 98.6%, and 98.6% respectively) while there was no association between SVR and other factors (p >0.05) such as gender, age, BMI, underlying cirrhosis, baseline HCV viral load, or prior treatment history. No serious adverse events were reported in the present study.ConclusionSofosbuvir-based regimens in the treatment of patients with chronic HCV infection were highly efficacious with excellent safety and tolerability profiles in a real-world setting; however, further research is required to establish whether or not such a regimen is an adequate treatment for all genotype 6 patients.

Highlights

The hepatitis C virus (HCV) was discovered in the late 1980s[1] and was found to be a major cause of cirrhosis and hepatocellular carcinoma
Sofosbuvir-based regimens in the treatment of patients with chronic HCV infection were highly efficacious with excellent safety and tolerability profiles in a real-world setting; further research is required to establish whether or not such a regimen is an adequate treatment for all genotype 6 patients
It has been found to achieve a low rate of sustained virological response (SVR) of about 40% in HCV GT1 infected patients and 60–80% of HCV GT2 or 3 infected patients. [6, 7] Its adverse effects can be substantial, including flu-like symptoms, psychiatric disorders, and hematologic effects, making it intolerable for a considerable number of patients.[8]

Summary

Introduction

The hepatitis C virus (HCV) was discovered in the late 1980s[1] and was found to be a major cause of cirrhosis and hepatocellular carcinoma. The worldwide population infected with HCV is estimated at 71 million individuals,[2] while in Thailand its incidence is 1–2% of the population.[3] There are seven genotypes (GT) of HCV, and these are distributed unevenly worldwide. GT1 is the most prevalent in the western world,[4] in Thailand, HCV GT3 is most common at 46.1%, followed by GT1, GT6 and GT2 at 32.5%, 20.9%, and 0.5% respectively.[5]. Combination therapy of pegylated interferon (Peg-IFN) and ribavirin (RBV) has been the cornerstone treatment for HCV infection. It has been found to achieve a low rate of sustained virological response (SVR) of about 40% in HCV GT1 infected patients and 60–80% of HCV GT2 or 3 infected patients. It has been found to achieve a low rate of sustained virological response (SVR) of about 40% in HCV GT1 infected patients and 60–80% of HCV GT2 or 3 infected patients. [6, 7] Its adverse effects can be substantial, including flu-like symptoms, psychiatric disorders, and hematologic effects, making it intolerable for a considerable number of patients.[8]

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Conclusion