التفاصيل البيبلوغرافية
| العنوان: |
High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis With 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study. |
| المؤلفون: |
Flower, Barnaby, McCabe, Leanne, Ngoc, Chau Le, Manh, Hung Le, Thanh, Phuong Le, Trong, Thuan Dang, Thi, Thu Vo, Kim, Hang Vu Thi, Tat, Thanh Nguyen, Hong, Dao Phan Thi, Chau, An Nguyen Thi, Thi, Tan Dinh, Tuyet, Nga Tran Thi, Tarning, Joel, Kingsley, Cherry, Kestelyn, Evelyne, Pett, Sarah L, Thwaites, Guy, Van, Vinh Chau Nguyen, Smith, David |
| المصدر: |
Open Forum Infectious Diseases; Jul2021, Vol. 8 Issue 7, p1-9, 9p |
| مصطلحات موضوعية: |
FIBROSIS, HEPATITIS C virus, GENOTYPES, VIRAL load, SOFOSBUVIR, LIVER |
| مصطلحات جغرافية: |
VIETNAM |
| الشركة/الكيان: |
WORLD Health Organization |
| مستخلص: |
Background Genotype 6 is the most genetically diverse lineage of hepatitis C virus, and it predominates in Vietnam. It can be treated with sofosbuvir with daclatasvir (SOF/DCV), the least expensive treatment combination globally. In regional guidelines, longer treatment durations of SOF/DCV (24 weeks) are recommended for cirrhotic individuals, compared with other pangenotypic regimens (12 weeks), based on sparse data. Early on-treatment virological response may offer means of reducing length and cost of therapy in patients with liver fibrosis. Methods In this prospective trial in Vietnam, genotype 6-infected adults with advanced liver fibrosis or compensated cirrhosis were treated with SOF/DCV. Day 14 viral load was used to guide duration of therapy: participants with viral load <500 IU/mL at day 14 were treated with 12 weeks of SOF/DCV and those ≥500 IU/mL received 24 weeks. Primary endpoint was sustained virological response (SVR). Results Of 41 individuals with advanced fibrosis or compensated cirrhosis who commenced treatment, 51% had genotype 6a and 34% had 6e. The remainder had 6h, 6k, 6l, or 6o. One hundred percent had viral load <500 IU/mL by day 14, meaning that all received 12 weeks of SOF/DCV. One hundred percent achieved SVR12 despite a high frequency of putative NS5A inhibitor resistance-associated substitutions at baseline. Conclusions Prescribing 12 weeks of SOF/DCV results in excellent cure rates in this population. These data support the removal of costly genotyping in countries where genotype 3 prevalence is <5%, in keeping with World Health Organization guidelines. NS5A resistance-associated mutations in isolation do not affect efficacy of SOF/DCV therapy. Wider evaluation of response-guided therapy is warranted. [ABSTRACT FROM AUTHOR] |
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