Newer DAAs Better for HCV Genotype 3 vs Older Ones
Regimens for genotype 3 hepatitis C virus (HCV) infection that incorporate newer direct-acting antivirals (DAAs) are more effective than those that incorporate older DAAs, according to a recent systematic review. In addition, ribavirin may be less beneficial in these newer DAA regimens vs older ones.
Genotype 3 is the second-most common genotype of HCV and is more difficult to treat due to its aggressiveness.
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To explore the best treatment options for this patient population, the researchers performed a systematic review and descriptive statistical analysis of observational studies and clinical trials conducted between February 2011 and May 2016 based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Data were obtained from PubMed, Medline In-Process, and EMBASE.
Findings from the analysis showed that, of the all-oral regimens that had been studied, sofosbuvir + daclatasvir- and velpatasvir-based regimens were most efficacious, which supported their recommendation by guidelines (sustained virologic response at 12 weeks or more [SVR12], 90%). The researchers also noted that regimens containing grazoprevir + elbasvir + sofosbuvir, and ombitasvir + paritaprevir/ribavirin + sofosbuvir were promising treatments for genotype 3 infection.
Results of the analysis also found that the SVR12 rates associated with newer, all-oral, ribavirin-free regimens comprising pibrentasvir + glecaprevir or grazoprevir + ruzasvir + uprifosbuvir had been consistently greater than 95%.
“On the basis of SVR12, we established that for treating [genotype 3] infections (i) regimens incorporating newer DAAs are more effective than those comprising older DAAs, and (ii) ribavirin may be of less benefit in newer DAA regimens than in older DAA regimens,” the researchers concluded. “The analysis provides evidence that DAA regimens can replace Peg-IFN-based regimens for [genotype 3] infection.”
Fathi H, Clark A, Hill NR, Dusheiko G. Effectiveness of current and future regimens for treating genotype 3 hepatitis C virus infection: a large-scale systematic review [published online November 16, 2017]. BMC Infect Dis. https://doi.org/10.1186/s12879-017-2820-z.