Four Weeks Treatment with Glecaprevir/Pibrentasvir + Ribavirin—A Randomized Controlled Clinical Trial

Abstract

Enhancing treatment uptake for hepatitis C to achieve the elimination goals set by the World Health Organization could be achieved by reducing the treatment duration. The aim of this study was to compare the sustained virological response at week 12 (SVR12) after four weeks of glecaprevir/pibrentasvir (GLE/PIB) + ribavirin compared to eight weeks of GLE/PIB and to estimate predictors for SVR12 with four weeks of treatment through a multicenter open label randomized controlled trial. Patients were randomized 2:1 (4 weeks:8 weeks) and stratified by genotype 3 and were treatment naïve of all genotypes and without significant liver fibrosis. A total of 27 patients were analyzed for predictors for SVR12, including 15 from the first pilot phase of the study. In the ‘modified intention to treat’ group, 100% (7/7) achieved cure after eight weeks and for patients treated for four weeks the SVR12 was 58.3% (7/12). However, patients with a baseline viral load <2 mill IU/mL had 93% SVR12. The study closed prematurely due to the low number of included patients due to the COVID-19 pandemic. Our results suggest that viral load should be taken into account when considering trials of short course treatment.

Glecaprevir-Pibrentasvir and Ethinyl Estradiol-Induced Liver Injury in a Patient Without Cirrhosis

“…The management of GP-induced DILI is the discontinuation of the treatment once the liver injury has been linked to GP. This has demonstrated a subsequent improvement in liver function tests within a matter of weeks [5][6][7]13]. One retrospective cohort study suggested the potential benefit of adding ursodeoxycholic acid to manage GP-induced liver injury while maintaining therapy, even with significant hyperbilirubinemia >2 [14].…”

Virologic Response and Reinfection Following HCV Treatment among Hospitalized People Who Inject Drugs: Follow-Up Data from the OPPORTUNI-C Trial

“…Thus, the similar SVR rates could be explained by the intervention reaching more marginalized individuals at higher risk of loss to follow-up rather than the intervention being ineffective. Furthermore, because high SVR rates can be achieved despite suboptimal adherence [ 39 ] or treatment interruption [ 40 ], SVR is probably underestimated among intervention participants.…”

Sofosbuvir plus velpatasvir for 8 weeks in patients with acute hepatitis C: The HepNet acute HCV-V study

“…However, it is quite possible that all patients, including the lost-to-follow-up cases, have eliminated HCV, since they have received the therapy for a few weeks and even 4 weeks DAA therapy may be effective in a substantial number of patients. 22 …”