Treatment adherence and virological response rates in hepatitis C virus infected persons treated with sofosbuvir-based regimens: results from ERCHIVES

被引:24
作者
Butt, Adeel A. [1 ,2 ,3 ,4 ,5 ]
Yan, Peng [1 ]
Shaikh, Obaid S. [1 ,6 ]
Chung, Raymond T. [7 ,8 ]
Sherman, Kenneth E. [9 ]
机构
[1] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA
[2] Hamad Healthcare Qual Inst, Doha, Qatar
[3] Hamad Med Corp, Doha, Qatar
[4] Weill Cornell Med Coll, Doha, Qatar
[5] Weill Cornell Med Coll, New York, NY USA
[6] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA
[7] Massachusetts Gen Hosp, Boston, MA 02114 USA
[8] Harvard Med Sch, Boston, MA USA
[9] Univ Cincinnati, Coll Med, UC Hlth, Cincinnati, OH USA
关键词
adherence; directly acting antiviral agents; ERCHIVES; HCV; sofosbuvir; HIV/HCV-COINFECTED PATIENTS; TREATMENT-NAIVE PATIENTS; PEGYLATED INTERFERON; PHASE-2; TRIAL; HCV TREATMENT; BOCEPREVIR; TELAPREVIR; RIBAVIRIN; SURVIVAL; THERAPY;
D O I
10.1111/liv.13103
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Role of non-adherence upon virological success with newer oral regimens is unknown. We sought to determine the impact of treatment adherence upon virological outcomes in hepatitis C virus (HCV) infected persons on sofosbuvir (SOF)-based regimens, using pharmacy prescription data as a measure of adherence. Methods: We analysed HCV infected persons in Electronically Retrieved Cohort of HCV Infected Veterans, who were initiated on SOF-based regimens, excluding those with human immunodeficiency virus, positive hepatitis-B surface antigen, hepatocellular carcinoma and missing HCV RNA. Results: The final dataset included following regimens: SOF+simeprevir (SIM) (n = 1050), SOF+ledipasvir (LDV) (n = 974), SOF+ribavirin (RBV) (n = 663, genotype 2 or 3), and SOF+pegylated interferon (PEG)+RBV (n = 519, genotype 1 or 4). Those treated with a SOF-based regimen were older and more likely to have cirrhosis, diabetes, chronic kidney disease, higher HCV RNA levels, higher body mass index, compared with 1652 controls receiving a boceprevir-based (BOC) regimen. Sustained virological response (SVR12) rates for the SOF+SIM and SOF+LDV groups did not decline significantly even when as low as 50% of the full course was prescribed (except SOF+LDV, 90-99% prescriptions had SVR12 of 84.6%; n = 13). SOF+RBV for genotype 2/3 who received 50-80% of the prescriptions, 23/34 (67.6%) achieved SVR12. For persons with genotype 1/4 infection treated with SOF+PEG+RBV, no declines in SVR12 were seen with lower rates of prescriptions (40/43, or 93% SVR12 rate). Conclusions: Sofosbuvir-based treatment regimens are highly effective in achieving SVR12. This efficacy is not significantly affected when treated persons receive less than a full prescribed course of treatment.
引用
收藏
页码:1275 / 1283
页数:9
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