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Comparison of three therapeutic regimens for genotype‐3 hepatitis C virus infection in a large real‐life multicentre cohort
Author(s) -
Soria Alessandro,
Fava Marco,
Bernasconi Davide P.,
Lapadula Giuseppe,
Colella Elisa,
Valsecchi Maria G.,
Migliorino Guglielmo M.,
D'Ambrosio Roberta,
Landonio Simona,
Schiavini Monica,
Spinetti Angiola,
Carriero Canio,
Degasperi Elisabetta,
Cologni Giuliana,
Gatti Federico,
Viganò Paolo,
Hasson Hamid,
UbertiFoppa Caterina,
Pasulo Luisa,
Baiguera Chiara,
Rossotti Roberto,
Vinci Maria,
Puoti Massimo,
Giorgini Alessia,
Menzaghi Barbara,
Lombardi Andrea,
Pan Angelo,
Aghemo Alessio,
Grossi Paolo A.,
Boldizzoni Roberto,
Colombo Silvia,
Viganò Mauro,
Rumi Maria G.,
Del Poggio Paolo,
Valenti Luca,
Giglio Omar,
De Bona Anna,
d'Arminio Monforte Antonella,
Colombo Alberto,
Spinelli Ombretta,
Pigozzi Marie G.,
Molteni Chiara,
Bonfanti Paolo,
Terreni Natalia,
Perini Paolo,
Capretti Andrea,
Bella Daniele,
Liani Cecilia,
Polo Silvia,
Aimo Gianpiero,
Pagnucco Layla,
Bhoori Sherrie,
Centenaro Riccardo,
Graffeo Massimo,
Ciaccio Antonio,
Dionigi Elena,
Lazzaroni Sergio,
Carderi Isabella,
Di Marco Mariella,
Rizzardini Giuliano,
Noventa Franco,
Lampertico Pietro,
Fagiuoli Stefano
Publication year - 2020
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.14386
Subject(s) - sofosbuvir , ribavirin , medicine , regimen , hepatitis c virus , cohort , hepatitis c , logistic regression , daclatasvir , univariate analysis , gastroenterology , multivariate analysis , virology , virus
Background & Aims In the direct‐acting antiviral era, treatment of genotype‐3 HCV (HCV‐GT3) is still challenging. Real‐life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV‐GT3 patients consecutively treated within the Lombardia web‐based Navigatore HCV‐Network; differences in SVR12 across regimens were evaluated by logistic regression. Results Of the 2082 subjects with HCV‐GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV‐positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV‐RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB ( P = .065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P = .007) and lower median pretreatment Log 10 HCV‐RNA (5.87 vs 6.20, P = .001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV‐RNA were independently associated with SVR12. Conclusions In a large real‐life setting of HCV‐GT3‐infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier‐to‐treat patients allows ribavirin‐free and shorter schedules without mining SVR12 in this <> genotype.