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Daclatasvir, Sofosbuvir With or Without Ribavirin for 24 Weeks In Hepatitis C Genotype 3 Cirrhosis: A Real-Life Study

2018; Elsevier BV; Volume: 17; Issue: 5 Linguagem: Inglês

10.5604/01.3001.0012.4901

2659-5982

Raffaella Lionetti, Paola Piccolo, I. Lenci, Massimo Siciliano, Ubaldo Visco‐Comandini, A. De Santis, Maurizio Pompili, Martina Milana, Chiara Taibi, Serena Dell’Isola, Marzia Montalbano, Claudio Maria Mastroianni, Paola Begini, Anna Rosa Garbuglia, M. Angélico, Gianpiero D’Offizi,

Hepatitis B Virus Studies

Introduction and aim: Cirrhotic patients with hepatitis C virus genotype 3 infection show unsatisfactory outcomes after 12 weeks’ treatment with direct antiviral agents. The National Italian Drug Agency allows 24 weeks of therapy in difficult-to-treat patients, including genotype 3 cirrhotics . Aim of this study was to evaluate efficacy and safety of a 24-week course of sofosbuvir plus daclatasvir±ribavirin in this population. Materials and methods: 106 consecutive cirrhotics (70.8% males, mean age 55.3±7.6 years) in 8 tertiary hepatology centers received sofosbuvir plus daclatasvir for 24 weeks. Ribavirin was administered in 85 (80.2%) based expected tolerability, at a mean dose of 964±202 mg/day. Baseline Child-Pugh class was A 91.5%, B 6.6%, C 1.9%; mean baseline MELD was 8.5±2.7. Results: All patients completed 12-week follow-up post-treatment, and 104 (98.1%) obtained sustained virologcal response (100% in ribavirin -treated patients vs 90.4% without ribavirin; p=0.04). No worsening in renal and liver function was observed, no serious adverse events occurred. Two virological failures showed resistance associated variants (Y93H and S282T). Conclusion: An extended 24-week treatment with sofosbuvir plus daclatasvir+ribavirin obtained 100% efficacy in genotype 3 hepatitis C cirrhosis, with very limited side effects. The role of ribavirin seems crucial in this setting and should be administered if clinically feasible.