Treatment of chronic hepatitis C genotype 3 with Sofosbuvir-based therpy: a real-life study

Hepatol Int. 2017 May;11(3):277-285. doi: 10.1007/s12072-017-9794-1. Epub 2017 Mar 31.

Abstract

Background and aims: Recently, Sofosbuvir was launched in India at affordable cost. We conducted a real-life study to determine the efficacy and safety of Sofosbuvir plus Ribavirin, with and without peginterferon-alfa 2a, in patients with chronic hepatitis C (CHC) genotype 3, the commonest genotype in South Asia.

Methods: This study included data of CHC patients from 11 sites in northern India between March 2015 and December 2015 (n = 1203). Patients with CHC genotype 3 (n = 931), who were treated with either Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×24 weeks (n = 432) (dual therapy), or Peginterferon-α2a 180 mcg weekly, Sofosbuvir 400 mg plus weight-based Ribavirin, daily ×12 weeks (n = 499) (triple therapy) were included for analysis. Primary outcome was the proportion of patients achieving sustained viral response at 12 weeks post-therapy.

Results: The overall SVR rates were 91 and 92% in the dual and triple therapy arms, respectively. The SVR rates in treatment experienced were 67 and 74% versus 93 and 96% in naïve patients, on the dual and triple therapy arms, respectively. The SVR rates of cirrhotics were 73 and 75% on the dual and triple treatment arms, respectively. The SVR rates were low in the experienced cirrhotic patients: 44% (dual therapy) and 58% (triple therapy). Common adverse events were fatigue, headache, and myalgia.

Conclusion: Both dual and triple therapy regimes resulted in SVR rates of >95% in CHC genotype 3 who were naive non-cirrhotics. However, the SVR rates were low in treatment-experienced cirrhotics.

Keywords: Chronic hepatitis C; Pegylated interferon; Sofosbuvir and Ribavirin.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Asia / epidemiology
  • Drug Therapy, Combination / methods*
  • Drug Therapy, Combination / trends
  • Female
  • Genotype
  • Hepacivirus / drug effects
  • Hepacivirus / genetics*
  • Hepatitis C, Chronic / drug therapy
  • Humans
  • India / epidemiology
  • Interferon-alpha / administration & dosage
  • Interferon-alpha / adverse effects
  • Interferon-alpha / pharmacology*
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / drug therapy
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / pharmacology*
  • RNA Viruses / drug effects
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / pharmacology
  • Retrospective Studies
  • Ribavirin / administration & dosage
  • Ribavirin / adverse effects
  • Ribavirin / pharmacology*
  • Sofosbuvir / administration & dosage
  • Sofosbuvir / adverse effects
  • Sofosbuvir / pharmacology*
  • Sustained Virologic Response
  • Treatment Outcome
  • Viral Load / drug effects

Substances

  • Antiviral Agents
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a
  • Sofosbuvir