Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Feb;31(1):35-42.
Epub 2018 Jan 29.

Interferon-free treatments in patients with hepatitis C genotype 3 infection in a tertiary hospital

J C Del Rio-Valencia, R Asensi-Diez  1 , R Madera-Pajin, L Yunquera-Romero, I Muñoz-Castillo
Affiliations
Observational Study

Interferon-free treatments in patients with hepatitis C genotype 3 infection in a tertiary hospital

J C Del Rio-Valencia et al. Rev Esp Quimioter. 2018 Feb.

Abstract
in English, Spanish

Objective: Hepatitis C virus genotype 3 represents a unique entity within HCV treatment and multiple studies have documented that HCV genotype 3 infection is associated with more rapid disease progression than other genotypes, resulting in increased risk of cirrhosis, hepatocellular carcinoma, and all-cause mortality. In the current study, we further evaluated the real-world effectiveness of 12 weeks of ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV) and sofosbuvir + daclatasvir (SOF + DCV) for treatment-naive or treatment-experienced patients infected with HCV genotype 3, with or without cirrhosis.

Methods: Retrospective and observational study carried out in a third level hospital. Study period: April 2015 to January 2016. Inclusion criteria: Patients with HCV genotype-3 infection treated either with LDV/SOF ± RBV or with SOF + DCV during study period treated for 12 weeks. The patients that were treated during 24 weeks were excluded and those treated with peg-interferon. The main endpoint measured was the sustained virologic response (SVR) at 12 weeks (SVR12) and the secondary endpoint was SVR at 24 weeks (SVR24).

Results: During the study period, 603 patients were treated in our hospital: 71 with genotype 3. We included 46 patients who were treated with LDV/SOF ± RBV or SOF + DCV for 12 weeks. A 43.75% (7/16) of all patients treated with LDV/SOF achieved SVR12, 90% (9/10) of the patients treated with LDV/SOF+RBV achieved SVR12 and 95% (19/20) of the patients treated with SOF+DCV achieved SVR12. There was statistically significant difference (p=0.001) between LDV/SOF respect to SOF+DCV and between LDV/SOF with regard to LDV/SOF +RBV (p=0.018) used to treat HCV genotype 3 infection.

Conclusions: In conclusion, in our cohort of patients, the combination of SOF + DCV followed by LDV/SOF + RBV 12 weeks were the most effective in patients with HCV genotype 3 and with cirrhosis (SVR12 90% and 80%, respectively) and in those without cirrhosis (SVR12 100% in both combinations). All patients who achieved SVR12 also achieved SVR24, regardless of the regimen received.

Introducción: El virus de la hepatitis C (VHC) genotipo 3 representa una entidad única dentro del tratamiento de la hepatitis C y múltiples estudios sugieren que la infección del VHC genotipo 3 está asociada a una progresión más rápida de la enfermedad comparado con otros genotipos, resultando en un mayor riesgo de cirrosis, carcinoma hepatocelular y mortalidad. En el presente estudio se evaluó la efectividad del tratamiento ledipasvir/sofosbuvir ± ribavirina (LDV/SOF ± RBV) y sofosbuvir + daclatasvir (SOF + DCV) durante 12 semanas en pacientes con VHC genotipo 3 naive o pre-tratados, con o sin cirrosis.

Material y métodos: Se realizó un estudio observacional, retrospectivo en un hospital de tercer nivel. El periodo de estudio comprendió 9 meses (abril 2015-enero 2016). Criterios de inclusión: pacientes con hepatitis C y genotipo 3 que fueron tratados con LDV/SOF ± RBV o con SOF + DCV durante 12 semanas. Los pacientes que fueron tratados durante 24 semanas fueron excluidos así como aquellos que se trataron con peginteferon. La variable principal fue la respuesta viral sostenida (RVS) a semana 12 (RVS12) y la variable secundaria fue RVS24.

Resultados: En el periodo de estudio se trataron en nuestro hospital 603 pacientes: 71 con genotipo 3. Se incluyeron en el análisis 46 pacientes, que fueron tratados con LDV/SOF ± RBV o SOF + DCV durante 12 semanas. El 43,75% (7/16) de todos los pacientes tratados con LDV/SOF alcanzaron RVS12, el 90% (9/10) de los pacientes tratados con LDV/SOF + RBV consiguieron RVS12 y el 95% (19/20) de los pacientes tratados con SOF + DCV. Se obtuvieron diferencias significativas (p=0,001) entre LDV/SOF y SOF + DCV y entre LDV/SOF + RBV y LDV/SOF (p=0,018).

Conclusiones: En nuestra cohorte de pacientes, las combinaciones de SOF + DCV y LDV/SOF + RBV, administrados durante 12 semanas, fueron las más efectivas tanto en pacientes con cirrosis (RVS12 90% y 80%, respectivamente), como en pacientes sin cirrosis (RVS12 100% en ambos casos). Todos los pacientes que alcanzaron RVS12, también alcanzaron RVS24 independientemente del tratamiento recibido.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest

Figures

Figure 1
Figure 1
Percentage of patients who have achieved SVR12 with the different treatments analysed.
Figure 2
Figure 2
Percentage of different subgroups of patients (n = 16) who have achieved SVR12 with sofosbuvir/ledipasvir (SOF/LDV).
Figure 3
Figure 3
Percentage of different subgroups of patients (n = 10) who have achieved SVR12 with sofosbuvir/ledipasvir + rivabirin (SOF/LDV + RBV).
Figure 4
Figure 4
Percentage of different groups of patients (n = 20) who have achieved SVR12 with sofosbuvir plus daclatasvir (SOF + DCV).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new estimates of age-specific antibody to HCV seroprevalence. Hepatology. 2013; 57(4):1333–42. DOI: 10.1002/hep.26141 - DOI - PubMed
    1. Lam BP, Jeffers T, Younoszai Z, Fazel Y, Younossi ZM. The changing landscape of hepatitis C virus therapy: focus on interferon-free treatment. Therap Adv Gastroenterol. 2015; 8(5):298–312. DOI: 10.1177/1756283X15587481 - DOI - PMC - PubMed
    1. Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, Pybus OG, et al. . Global distribution and prevalence of hepatitis C virus genotypes. Hepatology. 2015; 61(1):77–87. DOI: 10.1002/hep.27259 - DOI - PMC - PubMed
    1. Feld JJ, Ramji A, Shafran SD, Willems B, Marotta P, Huchet E, et al. . Ledipasvir-Sofosbuvir Plus Ribavirin in Treatment-Naive Patients With Hepatitis C Virus Genotype 3 Infection: An Open-Label Study. Clin Infect Dis. 2017. 65(1): 13-19. DOI: 10.1093/cid/cix289 - DOI - PubMed
    1. Chan A, Patel K, Naggie S. Genotype 3 Infection: The Last Stand of Hepatitis C Virus. Drugs. 2017;77(2):131-144. DOI: 10.1007/s40265-016-0685-x - DOI - PMC - PubMed

Publication types

MeSH terms