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2017 ; 10
(1
): 68-73
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Prevalence of end of treatment RNA-positive/sustained viral response in HCV
patients treated with sofosbuvir combination therapies
#MMPMID28286560
Malespin M
; Benyashvili T
; Uprichard SL
; Perelson AS
; Dahari H
; Cotler SJ
Therap Adv Gastroenterol
2017[Jan]; 10
(1
): 68-73
PMID28286560
show ga
BACKGROUND: Some chronic hepatitis C virus (HCV), genotype 1 infected patients
treated with direct antiviral agents (DAAs) remain viremic at end of treatment
(EOT+), yet go on to achieve sustained virological response 12?weeks after
completion of therapy (SVR(12)). The incidence of EOT+/SVR in patients with
genotype 1 and other genotypes, as well as whether such patients achieve SVR(24)
remain in question. The aims of this study were to evaluate the frequency and
durability of EOT+/SVR(12&24) and other response categories in HCV genotype 1, 2,
or 3 infected patients treated with DAA in clinical practice. METHODS: Data from
patients treated with all oral sofosbuvir-based regimens at a university
hepatology practice by 1 July 2015 were reviewed retrospectively. Responses were
categorized based on virus levels during and post DAA treatment. HCV RNA levels
were measured by Abbott RealTime HCV (ART) or by Roche CobasTaqMan v2.0 (RCTM)
assays. RESULTS: The study population included 89 patients. Participants were 62%
genotype 1, 19% genotype 2 and 19% genotype 3, 54% cirrhotic and 46%
treatment-experienced. A total of 45 received sofosbuvir-simeprevir, 38
sofosbuvir-ribavirin and 6 sofosbuvir-ledipasvir. The SVR(12) rate was 82%. A
total of 5 patients (6%), all with genotype 1, had EOT+ by ART assay and each
achieved SVR(12&24). CONCLUSIONS: A total of 9% of genotype 1 patients (6%
overall) treated with DAAs were EOT+ by ART and all EOT+ cases achieved SVR(24).
EOT+/SVR was not observed with genotype 2 or 3 or by the RCTM assay. In patients
treated with DAAs, EOT+ by the ART assay does not indicate treatment failure.