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Is an 8‐week regimen of glecaprevir/pibrentasvir sufficient for all hepatitis C virus infected patients in the real‐world experience?

2020; Wiley; Volume: 36; Issue: 7 Linguagem: Inglês

10.1111/jgh.15337

1440-1746

Dorota Zarębska‐Michaluk, Jerzy Jaroszewicz, Paweł Pabjan, Tadeusz Wojciech Łapiński, Włodzimierz Mazur, Rafał Krygier, Dorota Dybowska, Waldemar Halota, Małgorzata Pawłowska, Ewa Janczewska, Iwona Buczyńska, Krzysztof Simon, Beata Dobracka, Jolanta Citko, Łukasz Laurans, Magdalena Tudrujek‐Zdunek, Krzysztof Tomasiewicz, Anna Piekarska, Marek Sitko, Jolanta Białkowska, Jakub Klapaczyński, Barbara Sobala‐Szczygieł, Andrzej Horban, Hanna Berak, Zbigniew Deroń, Beata Lorenc, Łukasz Socha, Olga Tronina, Robert Flisiak,

HIV/AIDS drug development and treatment

The revolution of the antiviral treatment of hepatitis C virus (HCV) infection resulting in higher effectiveness came with the introduction of direct-acting antivirals with pangenotypic regimens as a final touch. Among them, the combination of glecaprevir (GLE) and pibrentasvir (PIB) provides the opportunity for shortening therapy to 8 weeks in the majority of patients. Because of still insufficient evaluation of this regimen in the real-world experience, our study aimed to assess the efficacy and safety of 8-week GLE/PIB in chronic hepatitis C patients depending on liver fibrosis and genotype (GT).The analysis included patients who received GLE/PIB for 8 weeks selected from the EpiTer-2 database, large retrospective national real-world study evaluating antiviral treatment in 12 584 individuals in 22 Polish hepatology centers.A total of 1034 patients with female predominance (52%) were enrolled in the analysis. The majority of them were treatment naïve (94%), presented liver fibrosis (F) of F0-F3 (92%), with the most common GT1b, followed by GT3. The overall sustained virologic response after exclusion of nonvirologic failures was achieved in 95.8% and 98%, respectively (P = 0.19). In multivariate logistic regression HCV GT-3 (beta = 0.07, P = 0.02) and HIV infection (beta = -0.14, P < 0.001) were independent predictors of nonresponse.We demonstrated high effectiveness of 8-week GLE/PIB treatment in a non-GT3 population irrespective of liver fibrosis stage. Comparable efficacy was achieved in non-cirrhotic patients regardless of the genotype, including GT3 HCV.