title: Treatment adherence and virological response rates in hepatitis C virus infected persons treated with sofosbuvir-based regimens: results from ERCHIVES.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.|Hamad Healthcare Quality Institute and Hamad Medical Corporation, Doha, Qatar.|Weill Cornell Medical College, Doha, Qatar.|Weill Cornell Medical College, New York, NY, USA.
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Yan
authors.affiliation: VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.|University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Obaid S
authors.initials: OS
authors.lastname: Shaikh
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Chung
authors.affiliation: University of Cincinnati College of Medicine/UC Health, Cincinnati, OH, USA.
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Sherman
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011392:Proline / Q000031:analogs & derivatives / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D000069616:Simeprevir / Q000627:therapeutic use; D000069474:Sofosbuvir / Q000627:therapeutic use*; D000072230:Sustained Virologic Response; D014481:United States; D014728:Veterans; D016903:Drug Monitoring
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D007372:Interferons; D011392:Proline; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: ERCHIVES; HCV; adherence; directly acting antiviral agents; sofosbuvir