Retreatment of HCV With Combo Therapy Improves Outcomes

Retreatment with sofosbuvir plus grazoprevir/elbasvir plus ribavirin for 16 weeks improves rates of sustained virological response at 12 weeks (SVR12) among patients with hepatitis C virus (HCV) who did not respond to treatment with direct-acting antivirals (DAAs).

For their study, researchers evaluated the efficacy and safety of sofosbuvir plus grazoprevir/elbasvir plus ribavirin for 16 or 24 weeks in patients who did not respond to DAAs and who had evidence of resistance-associated substitutions (RAS). All patients were chronically infected with HCV genotype 1 or 4, and most had advanced fibrosis or compensated cirrhosis.
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Overall, all patients achieved HCV RNA below lower limit of quantification, and SVR12 has achieved by 25 of the 26 patients. The patient who did not achieve SVR12 died during the study, but their HCV RNA was negative at the time.

No patients discontinued treatment due to adverse effects or virological failure.

“In conclusion, our findings support the concept of retreating with sofosbuvir+ grazoprevir/elbasvir + ribavirin for 16 weeks GT1 or GT4 DAA-experienced patients with proven NS5A or NS3 RAS,” the researchers wrote.

—Michael Potts

Reference:

Ledinghen V, Laforest C, Hezode C, et al. Retreatment with sofosbuvir plus grazoprevir/elbasvir plus ribavirin of patients with hepatitis C virus genotype 1 or 4 who previously failed a NS5A or NS3-containing regimen. ANRS HC34 REVENGE [published online October 25, 2017]. Clinical Infectious Diseases. https://doi.org/10.1093/cid/cix916.