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VIRAL KINETICS PREDICT RESPONSE TO ALL-ORAL THERAPY AGAINST HCV GENOTYPE 3 INFECTION
Juan A. Pineda1, Luis E. Morano-Amado2, Rafael Granados3, Juan Macías4, Francisco Téllez5, Miguel García-Deltoro6, Maria J. Rios-Villegas7, Antonio Collado8, Karin Neukam4
1Hosp Univ de Valme, Seville, Spain,2Hosp Univ Alvaro Cunqueiro, Vigo, Spain,3Hosp Univ de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain,4Hosp Univ de Valme, Sevilla, Spain,5Hosp de La Línea, La Línea de la Concepción, Spain,6Hosp General de Valencia, Valencia, Spain,7Hosp Univ Virgen Macarena, Sevilla, Spain,8Hosp Univ Torrecárdenas, Almeria, Spain
Rates of sustained virologic response (SVR) to currently recommended therapy against hepatitis C virus (HCV) infection based on all-oral direct-acting antivirals (DAA) are generally high. However, in specific subsets, as it is the case for HCV genotype 3-infected, cirrhotic individuals, SVR rates can be suboptimal. The aim of this study was to determine the predictive capacity of response at week 4 for the achievement of sustained virologic response 12 weeks after the scheduled end of therapy date (SVR12) to treatment against HCV infection with all-oral DAA-based regimens.
From a prospective multicohort study, patients who completed a course of currently recommended DAA-based therapy at 33 Spanish hospitals and who had reached SVR12 evaluation timepoint were selected. Treatment week 4 HCV-RNA levels were categorized in target not detected (TND), below the lower limit of quantitation (LLOQTD) and ≥LLOQ.
A total of 818 patients were included. SVR12 rates [n/N (%)] for HCV genotypes 1a, 1b, 3 and 4 in an on-treatment approach were 275/282 (97.5%), 283/286 (99%), 114/123 (92.7%) and 123/127 (94.5%). Of the HCV genotype 3-infected patients, 86 (70%) received sofosbuvir/daclatasvir+/-ribavirin, 27 (22%) sofosbuvir/ledipasvir/ribavirin and 10 (8.1%) sofosbuvir/ribavirin, respectively. In this subgroup, in those that achieved TND, LLOQTD and ≥LLOQ, SVR12 was 81 (97.6%), 24 (85.7%) and 9 (75%), respectively; p (linear association)=0.001. Corresponding numbers for HCV genotype 3-infected subjects with cirrhosis were: 52 (96.3%), 14 (77.8%) and 7 (70%); p=0.004. There was no association between response at week 4 and SVR12 for the other HCV genotypes.
Treatment week 4-response indicates the probability to achieve SVR12 to currently used DAA-based therapy in HCV genotype 3-infected individuals. This finding may be useful to tailor treatment strategy in this setting.