Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P =.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P =.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P =.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <> genotype.
Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort / Soria, A.; Fava, M.; Bernasconi, D. P.; Lapadula, G.; Colella, E.; Valsecchi, M. G.; Migliorino, G. M.; D'Ambrosio, R.; Landonio, S.; Schiavini, M.; Spinetti, A.; Carriero, C.; Degasperi, E.; Cologni, G.; Gatti, F.; Vigano, P.; Hasson, H.; Uberti-Foppa, C.; Pasulo, L.; Baiguera, C.; Rossotti, R.; Vinci, M.; Puoti, M.; Giorgini, A.; Menzaghi, B.; Lombardi, A.; Pan, A.; Aghemo, A.; Grossi, P. A.; Boldizzoni, R.; Colombo, S.; Vigano, M.; Rumi, M. G.; Del Poggio, P.; Valenti, L.; Giglio, O.; De Bona, A.; d'Arminio Monforte, A.; Colombo, A.; Spinelli, O.; Pigozzi, M. G.; Molteni, C.; Bonfanti, P.; Terreni, N.; Perini, P.; Capretti, A.; Bella, D.; Liani, C.; Polo, S.; Aimo, G.; Pagnucco, L.; Bhoori, S.; Centenaro, R.; Graffeo, M.; Ciaccio, A.; Dionigi, E.; Lazzaroni, S.; Carderi, I.; Di Marco, M.; Rizzardini, G.; Noventa, F.; Lampertico, P.; Fagiuoli, S.. - In: LIVER INTERNATIONAL. - ISSN 1478-3223. - 40:4(2020), pp. 769-777. [Epub ahead of print] [10.1111/liv.14386]
Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort
Uberti-Foppa C.;
2020-01-01
Abstract
Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P =.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P =.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P =.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <> genotype.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
