dilluns, 21 d’agost del 2017

VHC: SOF/VEL pangenotípicos muestran gran eficacia en la fibrosis avanzada y la cirrosis

Sobretodo con el genotipo 3!

Sofosbuvir/Velpatasvir in Patients With Hepatitis C Virus Genotypes 1-6 and Compensated Cirrhosis or Advanced Fibrosis.

Abstract

BACKGROUND & AIMS:

Patients with chronic hepatitis C virus (HCV) infection and advanced fibrosis (Metavir F3) or cirrhosis (Metavir F4) have been identified as a priority group for immediate treatment. We evaluated the safety and efficacy of sofosbuvir-velpatasvir in patients with HCV genotype 1-6 infection and compensated cirrhosis or advanced fibrosis.

METHODS:

This retrospective analysis included 501 patients with compensated cirrhosis or advanced fibrosis (F3/F4), as defined by >0.59 on Fibrotest, >9.5 kPa on Fibroscan, or F3/F4 (Metavir) or F4 (Ishak) on liver biopsy. Patients received sofosbuvir-velpatasvir for 12 weeks. Sustained virological response 12 weeks after treatment (SVR12) was determined.

RESULTS:

Forty-four percent of patients had cirrhosis. SVR12 was achieved by 98% of patients (490/501; 95% CI, 96%-99%). SVR12 rates were 100% for HCV genotypes 2 (85/85), 4 (60/60), 5 (13/13), and 6 (20/20). SVR12 rates were 98% (167/170) in HCV genotype 1 patients and 95% (145/153) in HCV genotype 3 patients. Among patients with cirrhosis 96% (212/220) achieved SVR12, versus 99% (278/281) for those with advanced fibrosis. SVR12 was 98% (306/311) for treatment-naïve patients and 97% (184/190) for treatment-experienced patients. No patients discontinued treatment due to adverse events. Eight patients reported nine serious adverse events; none was considered related to study procedures or drugs.

CONCLUSIONS:

Sofosbuvir plus velpatasvir is highly effective and safe for treating patients with HCV genotypes 1, 2, 3, 4, 5, or 6 and advanced fibrosis or compensated cirrhosis. This article is protected by copyright. All rights reserved.

KEYWORDS:

NS5A inhibitor; antiviral agents; direct-acting antivirals; polymerase inhibitor
PMID:
 
28756625
 
DOI:
 
10.1111/liv.13534