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Treatment adherence and virological response rates in hepatitis C virus infected persons treated with sofosbuvir-based regimens: results from ERCHIVES.
- Source :
-
Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2016 Sep; Vol. 36 (9), pp. 1275-83. Date of Electronic Publication: 2016 Mar 24. - Publication Year :
- 2016
-
Abstract
- 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.<br />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.<br />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).<br />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.<br /> (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Aged
Databases, Factual
Drug Therapy, Combination
Female
Genotype
Hepacivirus genetics
Humans
Interferons therapeutic use
Logistic Models
Male
Middle Aged
Proline analogs & derivatives
Proline therapeutic use
Ribavirin therapeutic use
Simeprevir therapeutic use
Sustained Virologic Response
United States
Veterans
Antiviral Agents therapeutic use
Hepatitis C, Chronic complications
Hepatitis C, Chronic drug therapy
Liver Cirrhosis virology
Medication Adherence statistics & numerical data
Sofosbuvir therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1478-3231
- Volume :
- 36
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Liver international : official journal of the International Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 26928927
- Full Text :
- https://doi.org/10.1111/liv.13103