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Treatment adherence and virological response rates in hepatitis C virus infected persons treated with sofosbuvir‐based regimens: results from ERCHIVES
Author(s) -
Butt Adeel A.,
Yan Peng,
Shaikh Obaid S.,
Chung Raymond T.,
Sherman Kenneth E.
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13103
Subject(s) - sofosbuvir , medicine , simeprevir , ledipasvir , regimen , hepatitis c virus , boceprevir , ribavirin , ombitasvir , hepatitis c , pegylated interferon , gastroenterology , virology , virus
Abstract Background & Aims Role of non‐adherence upon virological success with newer oral regimens is unknown. We sought to determine the impact of treatment adherence upon virological outcomes in hepatitis C virus ( HCV ) infected persons on sofosbuvir ( SOF )‐based regimens, using pharmacy prescription data as a measure of adherence. Methods We analysed HCV infected persons in Electronically Retrieved Cohort of HCV Infected Veterans, who were initiated on SOF‐based regimens, excluding those with human immunodeficiency virus, positive hepatitis‐B surface antigen, hepatocellular carcinoma and missing HCV RNA . Results The final dataset included following regimens: SOF +simeprevir ( SIM ) ( n = 1050), SOF +ledipasvir ( LDV ) ( n = 974), SOF +ribavirin ( RBV ) ( n = 663, genotype 2 or 3), and SOF+pegylated interferon ( PEG )+ RBV ( n = 519, genotype 1 or 4). Those treated with a SOF‐based regimen were older and more likely to have cirrhosis, diabetes, chronic kidney disease, higher HCV RNA levels, higher body mass index, compared with 1652 controls receiving a boceprevir‐based ( BOC ) regimen. Sustained virological response ( SVR 12) rates for the SOF + SIM and SOF + LDV groups did not decline significantly even when as low as 50% of the full course was prescribed (except SOF + LDV , 90–99% prescriptions had SVR 12 of 84.6%; n = 13). SOF + RBV for genotype 2/3 who received 50–80% of the prescriptions, 23/34 (67.6%) achieved SVR 12. For persons with genotype 1/4 infection treated with SOF + PEG + RBV , no declines in SVR 12 were seen with lower rates of prescriptions (40/43, or 93% SVR 12 rate). Conclusions Sofosbuvir‐based treatment regimens are highly effective in achieving SVR 12. This efficacy is not significantly affected when treated persons receive less than a full prescribed course of treatment.