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J Viral Hepat ; 25(2): 118-125, 2018 02.
Article in English | MEDLINE | ID: mdl-28833938

ABSTRACT

The efficacy and safety of an investigational combination of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) plus sofosbuvir (SOF) ± ribavirin (RBV) in patients with HCV genotype 2 or 3 infection with or without cirrhosis was evaluated. Patients with HCV genotype 3 infection without cirrhosis were randomized to receive OBV/PTV/r + SOF ± RBV for 12 weeks; OBV/PTV/r + SOF + RBV was administered to genotype 3-infected patients with cirrhosis for 12 weeks and to genotype 2-infected patients without cirrhosis for either 6 or 8 weeks. Efficacy was assessed by sustained virologic response [HCV RNA <25 IU/mL] 12 weeks post-treatment (SVR12). Safety was assessed in all treated patients. In patients with genotype 3 infection with or without cirrhosis treated with 12 weeks of OBV/PTV/r + SOF ± RBV, the overall SVR12 rate was 98% (50/51), with no virologic failures. Patients with genotype 2 infection treated with OBV/PTV/r + SOF + RBV had SVR12 rates of 90% (9/10) and 44% (4/9) following 8- and 6-week treatment durations, respectively; failure to achieve SVR12 for these patients was due to relapse without baseline or treatment-emergent resistance-associated substitutions. Thus, the investigational combination of OBV/PTV/r with SOF ± RBV was well tolerated and achieved high SVR rates with no virologic failures in patients with genotype 3 infection. Combining direct-acting antivirals with complementary mechanisms of action and different viral targets may be an effective treatment strategy that may allow for shorter durations of therapy.


Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C/drug therapy , Liver Cirrhosis/drug therapy , Sustained Virologic Response , Adult , Aged , Anilides/administration & dosage , Anilides/therapeutic use , Antiviral Agents/administration & dosage , Carbamates/administration & dosage , Carbamates/therapeutic use , Cyclopropanes , Drug Therapy, Combination , Female , Genotype , Hepacivirus/genetics , Humans , Lactams, Macrocyclic , Liver Cirrhosis/virology , Macrocyclic Compounds/administration & dosage , Macrocyclic Compounds/therapeutic use , Male , Middle Aged , Proline/analogs & derivatives , RNA, Viral/blood , Ribavirin/administration & dosage , Ribavirin/therapeutic use , Ritonavir/administration & dosage , Ritonavir/therapeutic use , Sofosbuvir/administration & dosage , Sofosbuvir/therapeutic use , Sulfonamides , Treatment Outcome , Valine
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