Real‐world effectiveness of sofosbuvir‐based treatment regimens for chronic hepatitis C genotype 3 infection: Results from the multicenter German hepatitis C cohort (GECCO‐03)

Abstract

There are limited data regarding the real world effectiveness of direct acting antivirals (DAA) for the therapy of chronic genotype 3 hepatitis C virus (HCV) infection. All HCV genotype 3 infected patients from the German hepatitis C cohort (GECCO), which is a prospective database of nine German hepatitis C treatment centers, were included in the study. Three hundred forty-two chronically infected HCV genotype 3 patients were analyzed (253 males [74.0%], mean age 47.3 years, 127 cirrhotic patients [37.1%] mostly with Child A cirrhosis, 113 treatment experienced patients [37.1%], 38 HCV/HIV co-infected patients [11.1%]). SVR12 rates in the "intention-to-treat" analysis were as follows: sofosbuvir/ribavirin 69.4% (75/108), sofosbuvir/peginterferon/ribavirin 80.6% (58/72), sofosbuvir/daclatasvir ± ribavirin for 12 weeks 88.3% (53/63), sofosbuvir/daclatasvir ± ribavirin for 24 weeks 79.3% (23/29), sofosbuvir/ledipasvir ± ribavirin for 12 weeks 71.4% (10/14), and sofosbuvir/ledipasvir ± ribavirin for 24 weeks 86.7% (26/30). Forty patients were lost to follow-up, 23 patients had a relapse, 4 patients stopped treatment prematurely and 1 patient died. Female sex (P = 0.038) and treatment with two different DAAs (P = 0.05) were predictors for SVR12 in the multivariate analysis. In conclusion, sofosbuvir/daclatasvir ± ribavirin for 12 weeks and sofosbuvir/ledipasvir ± ribavirin for 24 weeks are effective for the treatment of HCV genotype 3 infected patients including cirrhotic, treatment-experienced or HIV/HCV co-infected patients.

Effectiveness and safety of original and generic sofosbuvir for the treatment of chronic hepatitis C: A real world study

“…We observed the lowest sustained virological response rate in patients infected with genotype 3 HCV, which is in line with recently published real‐world studies from Germany and France that focused on this genotype and described sustained virological rates of 78‐80% . As it was also previously reported, patients with the highest sustained virological response rates in our study were infected with genotypes 2 and 4 .…”

Introduction of the second-generation direct-acting antivirals (DAAs) in chronic hepatitis C: a register-based study in Sweden

“…It is not intended as a direct comparison between individual drugs, but to describe the patients treated and measure the extent to which the recommendations in the introduction protocol were implemented. Cure rates, based on data from 85% of the cohort, were generally as high as expected from either RCTs [17] or recent observational studies [18–23], with some variation between genotypes. Most of the patients were treated with the recommended combinations of the drugs under study, and the initially moderate adherence to the drug recommendations increased over time, with the increasing inclusion of drugs and drug combinations in the introduction protocol.…”

High efficacy of sofosbuvir/velpatasvir and impact of baseline resistance‐associated substitutions in hepatitis C genotype 3 infection

“…For the present study, all consecutive patients with chronic HCV GT3 infection treated with SOF/VEL with or without RBV for 12 weeks within the German Hepatitis C Cohort (GECCO) and at the outpatient clinic of the University Hospital Frankfurt were included. GECCO is an ongoing prospective, multicentre study including patients from 9 hepatitis C treatment centres in Germany (Berlin, Bonn, Duesseldorf, Frankfurt, Hamburg, Herne, Leverkusen, and Muenster) who initiated treatment with various DAA‐based regimens since February 2014 …”