Treatment of Real-World HCV Genotype 2-Infected Japanese Patients with Sofosbuvir plus Ribavirin

Abstract

The aim of this study was to characterize the treatment response and tolerability of sofosbuvir plus ribavirin therapies in Japanese patients infected with hepatitis C virus (HCV) genotype (GT)-2. This retrospective study analyzed 114 Japanese HCV GT-2 patients treated for 12 weeks with 400 mg of sofosbuvir plus weight-based ribavirin daily. This treatment led to higher sustained virologic response at 12-weeks post-treatment (SVR12) rates in both treatment-naïve and treatment-experienced patients. The efficacy of this treatment in compensated cirrhotics was the same as that in patients with chronic hepatitis. HCV GT-2a infection and lower estimated glomerular filtration rates (eGFR) tended to be associated with SVR12. Of 114 patients, 113 completed the combination of sofosbuvir plus ribavirin for 12 weeks. Seven patients without SVR12 did not have HCV NS5B-S282 mutations. The overall SVR12 rate was 90.4% (103 of 114). More effective therapeutic options with less adverse events are desired to achieve higher SVR rates in HCV GT-2 Japanese patients.

Sofosbuvir plus ribavirin for the treatment of hepatitis C virus genotype 2 in Korea: What's the optimal dosage of ribavirin in real‐world setting?

“…Although previous studies have reported lower SVR rates in patients with liver cirrhosis, different subtypes of genotype 2, a high baseline viral load, and prior treatment failure, we found no factors that were significantly related to the SVR rate in our study, probably because of the small sample size of those who failed to achieve SVR. A prior history of HCV treatment is regarded as a risk factor for treatment failure.…”

“…A prior history of HCV treatment is regarded as a risk factor for treatment failure. The proportion of patients with a history of prior HCV treatments was lower in the current study (13.4%) than in previous real-world studies (28%-34.2%), 14,16,17 which may explain the high SVR rate in this study. Some studies have reported low SVR rates in patients with cirrhosis who received 12 weeks of treatment.…”

“…The treatment regimen of glecaprevir plus pibrentasvir has been added to the recently updated 2017 KASL guidelines, which have not been released in Korea yet . Several studies on the use of sofosbuvir plus ribavirin for treating HCV genotype 2 infection have revealed substantial variations in sustained virological response (SVR) among distinct groups of patients, and the appropriate dosage of ribavirin for HCV treatment remains controversial because of its efficacy and safety issues . In the era of peginterferon plus ribavirin, despite a high likelihood of ribavirin dosage reduction, the ribavirin dosage starts from 1 200 mg/day or 1 000 mg/day because of a poor treatment response .…”

“…10 Several studies on the use of sofosbuvir plus ribavirin for treating HCV genotype 2 infection have revealed substantial variations in sustained virological response (SVR) among distinct groups of patients, and the appropriate dosage of ribavirin for HCV treatment remains controversial because of its efficacy and safety issues. [11][12][13][14][15][16][17] In the era of peginterferon plus ribavirin, despite a high likelihood of ribavirin dosage reduction, the ribavirin dosage starts from 1 200 mg/day or 1 000 mg/day because of a poor treatment response. 18 An increasing probability of anemia at a higher ribavirin dosage per body weight has been reported; considering the comparably lower weight in Asian populations, a fixed dose of 1 000 mg/day seems inadequate to apply in clinical practice for patients <75 kg (which applies to most of the patients).…”

Real‐world efficacy and safety of sofosbuvir + ribavirin for hepatitis C genotype 2: A nationwide multicenter study by the Japanese Red Cross Liver Study Group

“…The role of RBV adherence might affect SVR. Japanese real‐world data on the efficacy of SOF + RBV for genotype 2 infections have been reported, and there is disagreement on the impact of RBV dose reduction on SVR …”