Efficacy of Fixed-dose Combination of Sofosbuvir and Ledipasvir (SOF/LDV) ± Ribavirin (RBV) in Patients (n=130) Infected with HCV Genotype 6 (Real World Myanmar Experience)
Keywords:
Hepatitis C virus, genotype 6, sofosbuvir, ledipasvir, ribavirinAbstract
Background: The prevalence rate of HCV Genotype 6 is estimated to account for 36% of all HCV infections in Myanmar.
Objective: This study is aimed to assess the efficacy of SOF/LDV ± RBV in patients infected with HCV genotype 6.
Methods: We performed the prospective and observational study of 130 patients infected with chronic HCV genotype 6 (both treatment-naïve and treatment-experienced) was performed. The patients were treated with SOF/LDV ± RBV for 12 or 24 weeks.
Results: Overall SVR (sustained virologic response) rate was 77% of patients. Higher SVR rate was noted among the cirrhotic patients (p-value = 0.003) and treatment-experienced patients (p-value = 0.008). Co-infection with HBV was seen in 7 patients and all these patients achieved SVR12. In the study cohort, 104 patients were treatment-naïve and 26 patients were treatment-experienced. SVR rates of treatment-naïve patients with or without cirrhosis treated with SOF/LDV regimen for 12 weeks was 65% (n=47), SOF/LDV/RBV for 12 weeks was 82% (n=9) and SOF/LDV for 24 weeks was 91% (n=19). Twenty-six treatment-experienced patients were treated with SOF/LDV/RBV for 24 weeks and achieved 96% SVR rate.
Conclusion: SOF/LDV ± RBV therapy achieved SVR12 in 77% of all categories of genotype 6 patients demonstrating the unsatisfactory response and efficacy in the era of SVR rates approaching 100% in other genotypes. Therefore, our real-life experience showed genotype 6 as the most difficult to treat genotype. However, it was noted that the addition of RBV or extension of treatment duration can increase the SVR rates significantly.
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