Multiple DAAs provide quality care for HCV patients
Multiple oral direct-acting antiviral (DAA) regimens are safe, tolerable and effective in the treatment of hepatitis C virus (HCV) genotype 1 infection, particularly among patients without cirrhosis, according to a new systematic review.
“The HCV world and knowledge about treatments is evolving rapidly, with multiple trials published in many journals. We wanted to bring together everything in one place to help busy primary care physicians navigate this maze,” lead author Oluwaseun Falade-Nwulia, MBBS, MPH, assistant professor in the division of infectious disease at John Hopkins University, told Medical Economics.
The researchers published their results March 21, 2017 in Annals of Internal Medicine.
They conducted a systematic review of 42 published randomized controlled trials of 10 agents in all six HCV genotypes, as well as in patients with and without cirrhosis, previous treatment, HIV coinfection, and liver transplantation. The trials included patients who had received at least 8 weeks of an FDA-approved interferon-free HCV regimen that comprised at least two DAAs.
Six DAA regimens showed high sustained virologic response (SVR) rates of more than 95% in patients with HCV genotype 1 infection without cirrhosis, including those with HIV co-infection.
Two regimens — sofosbuvir plus velpatasvir or sofosbuvir plus daclatasvir for 12 weeks — were effective in HCV genotype 3 infection.
Serious adverse events and treatment discontinuation rates were less than 10%. The addition of ribavirin was associated with increased SVR rates for patients with HCV genotype 1a or 3 infection, cirrhosis, or previous treatment experience, and led to more mild or moderate adverse events.