Glecaprevir/pibrentasvir + sofosbuvir + ribavirin offers high cure rate for hepatitis C virus retreatment in real-world settings

Abstract

To the Editor:We read with interest the recent publication by Dietz et al. 1 and would like to present additional data regarding salvage HCV treatment in this difficult-to-cure patient population.

Reply to: “Glecaprevir/pibrentasvir + sofosbuvir + ribavirin offers high cure rate for hepatitis C virus retreatment in real-world settings”

“…The study conducted by Dr. Martin investigated 6 cirrhotic patients with a VOX/VEL/SOF treatment failure who were retreated with G/P+SOF+RBV and all patients achieved SVR. 4 The frequencies of baseline NS5A resistance-associated substitutions (RASs) was high and is in accordance with our findings. However, Dr. Martins study included a limited number of patients and, of note, only one-third of patients (n = 2/6) were infected with HCV GT3a.…”

Best therapy for the easiest to treat hepatitis C virus genotype 1b-infected patients

“…It should be noted, however, that the clinical studies involved a small group of DAA-experienced patients with GT1b infection treated with VOX/VEL/SOF, only 69 individuals participated in the POLARIS-1 and POLARIS-4 studies, and in the case of GLE/PIB + SOF + RBV therapy it was only one patient participating in the MAGELLAN-3 study. While RWE publications with a much larger number of patients and such characteristics confirming the high effectiveness of the VOX/VEL/SOF regimen are numerous, for the GLE/PIB + SOF + RBV option, data from routine clinical practice concern only two patients who responded to treatment[ 41 - 43 ].…”

Non-responders to sofosbuvir/velpatasvir/voxilaprevir in the treatment of chronic hepatitis C infection

“…There are no randomized controlled trials and few published reports (6 studies with 38 patients) addressing rescue treatment after SOF/VEL/VOX failure (Table 1). Of 32 SOF/VEL/VOX nonresponders treated in 6 studies 1,3,[6][7][8][9] with glecaprevir/pibrentasvir (GLE/PIB) (±sofosbuvir (SOF) and/or ±ribavirin for 12, 16, or 24 weeks), 28 (87.5%) achieved SVR12 (1 patient achieved SVR4 and died prior to SVR 12, 2 patients relapsed, and 1 other patient died). One patient had RAS testing after unsuccessful rescue treatment with GLE/PIB +SOF +ribavirin for 16 weeks; NS5A RASs (A30K, L31F, Y93H) were detected, no NS3 or NS5B RASs were detected.…”