Hepatocellular carcinoma or interferon-based therapy history attenuates sofosbuvir/ribavirin for Japanese genotype 2 hepatitis C virus

World J Gastroenterol. 2018 Apr 7;24(13):1478-1485. doi: 10.3748/wjg.v24.i13.1478.

Abstract

Aim: To investigate the real-world efficacy and safety of sofosbuvir/ribavirin (SOF/RBV) therapy for Japanese patients with genotype 2 hepatitis C virus (GT2-HCV).

Methods: A total of 182 patients with GT2-HCV infection who received SOF/RBV therapy for 12 wk at our hospital were enrolled. The patients comprised 122 men and 60 women (age range: 17-84 years; mean age ± SD: 60.1 ± 12.1 years). Relationships between virological response and clinical data were examined by logistic regression analyses.

Results: The proportions of patients with liver cirrhosis and history of hepatocellular carcinoma (HCC) were 29.0% and 17.3%, respectively. The proportion of patients with prior interferon (IFN)-based therapy was 25.6%. SOF/RBV therapy rapidly decreased HCV RNA levels. Several patients required RBV dose reduction because of anemia or fatigue. Four patients discontinued the therapy. The rates of sustained virological response at 12 wk after the end of treatment were 87.9% (intention to treat: 160/182) and 94.1% (per protocol: 159/169). Multivariate analyses showed that history of HCC or IFN-based therapy independently reduced the efficacy of SOF/RBV therapy.

Conclusion: SOF/RBV therapy for GT2-HCV is safe, highly tolerated, and effective. History of HCC or IFN-based therapy independently reduces the efficacy of this treatment.

Keywords: Genotype 2; Hepatitis C virus; Hepatocellular carcinoma; Interferon-based therapy; Ribavirin; Sofosbuvir.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / pathology
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Female
  • Genotype
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepacivirus / isolation & purification
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / pathology
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferons / therapeutic use
  • Japan / epidemiology
  • Liver Cirrhosis / epidemiology*
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Ribavirin / therapeutic use
  • Sofosbuvir / therapeutic use
  • Sustained Virologic Response
  • Treatment Outcome
  • Young Adult

Substances

  • Antiviral Agents
  • Ribavirin
  • Interferons
  • Sofosbuvir