Effectiveness and Safety of Sofosbuvir-Based Regimens for Chronic HCV Genotype 3 Infection: Results of the HCV-TARGET Study.
Sofosbuvir (SOF) is active against all hepatitis C virus (HCV) genotypes, and SOF-based therapies lead to high rates of sustained virologic response (SVR). However, genotype 3 (GT3) HCV remains a challenge with lower SVR rates reported, particularly in patients with cirrhosis. This study reports the effectiveness and safety of SOF-based therapy in patients with GT3 HCV treated in clinical practice.



Hepatitis C Virus Therapeutic Registry and Research Network is an international, prospective observational study evaluating patients treated in usual clinical practice. Patients with GT3 HCV were analyzed to assess predictors of treatment response and adverse events using descriptive statistics and multivariable logistic regression.



Treatment outcomes were available for 197 patients treated with SOF and ribavirin (RBV), with or without peginterferon, including 54% with cirrhosis and 49% who failed prior therapy. Of 178 patients treated with SOF/RBV, 60% achieved SVR at 12 weeks (SVR12), compared with 84% of 19 patients treated with SOF/peginterferon/RBV. For patients treated with SOF/RBV, the SVR12 rate was 58% in treatment-naive patients with cirrhosis, and 42% in those with cirrhosis who failed prior therapy. In noncirrhotic patients, SVR12 rates were 89% in treatment-naive and 88% in treatment-experienced patients. After controlling for age and sex, absence of cirrhosis (odds ratio [OR], 6.4; 95% confidence interval [CI], 2.78-14.74), albumin levels ≥3.2 g/dL (OR, 12.48; 95% CI, 3.86-40.33), and platelet count >10(5) cells/µL (OR, 7.44; 95% CI, 3.51-15.78) were associated with greater odds of SVR12 CONCLUSIONS:  SVR rates were acceptable in patients with GT3 HCV without cirrhosis; however, in those with cirrhosis, treatment with SOF/RBV was suboptimal, highlighting the need for new therapies for this population.
Toronto Centre for Liver Disease, Sandra Rotman Centre for Global Health, University of Toronto, Ontario, Canada.
Jordan J
JJ
Feld
Toronto Centre for Liver Disease, Sandra Rotman Centre for Global Health, University of Toronto, Ontario, Canada.|Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Raoel
R
Maan
Goethe University Hospital, Frankfurt, Germany.
Stefan
S
Zeuzem
University of California, San Diego.
Alexander
A
Kuo
University of Florida, Gainesville.
David R
DR
Nelson
Saint Louis University School of Medicine, Missouri.
Adrian M
AM
Di Bisceglie
Hannover Medical School, Germany.
Michael P
MP
Manns
University of Cincinnati, Ohio.
Ken
K
Sherman
Liver Wellness Center, Little Rock, Arkansas.
Lynn M
LM
Frazier
Virginia Commonwealth University Health System, Richmond.
Richard
R
Sterling
University of Nebraska Medical Center, Omaha.
Mark
M
Mailliard
University of North Carolina, Chapel Hill.
Monica
M
Schmidt
Carolinas Healthcare System, Charlotte, North Carolina.
Lucy
L
Akushevich
Carolinas Healthcare System, Charlotte, North Carolina.
Monika
M
Vainorius
Carolinas Healthcare System, Charlotte, North Carolina.
Michael W
MW
Fried
D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D000069474:Sofosbuvir / Q000009:adverse effects / Q000627:therapeutic use; D000072230:Sustained Virologic Response; D055815:Young Adult
D000998:Antiviral Agents; D012254:Ribavirin; D000069474:Sofosbuvir
cirrhosis; genotype 3; interferon; ribavirin; sofosbuvir