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Glecaprevir–pibrentasvir regimen effective against genotype 2 HCV in haemodialysis patients

29 Jul 2019

An 8- or 12-week regimen of glecaprevir plus pibrentasvir (G/P) appears to be safe and effective in the treatment of genotype 2 hepatitis C virus (HCV) infection in patients undergoing haemodialysis, as reported in a recent Japanese cohort study.

Researchers followed a total of 27 patients who initiated G/P regimen. Thirteen nonliver cirrhosis (LC) and direct-acting antivirals (DAAs)-naïve patients received the 8-week regimen, while 14 patients with LC (n=13) or history of DAA failure (n=1) received the 12-week regimen.

All but one patient (96.3 percent) achieved sustained virological response at 12 weeks following treatment completion (SVR12). There were two cases of treatment withdrawal: one was at week 11 due to cerebral infarction (which was resolved by conservative management) and the other was at week 2 due to exacerbation of pruritis. The patient who discontinued G/P at week 2 belonged to the 12-week regimen arm and could not achieve SVR12.

Adverse events occurred in 51.9 percent (14/27) of the population, with the most common being pruritus (29.6 percent; 8/27). None of the patients experienced lethal adverse events.

Glecaprevir is a novel HCV NS5A inhibitor, while pibrentasvir is an HCV protease inhibitor. Notably, these drugs could initially reduce the treatment duration for HCV-infected patients without liver cirrhosis. The efficacy of the G/P regimen has also been demonstrated in a previous trial involving patients with severe renal dysfunction, but the treatment duration was standardized to 12 weeks.  [J Gastroenterol 2018;53:557-565; Hepatology 2018;68:1298-1307; N Engl J Med 2017;377:1448-1555]

Therefore, the present data show that a shorter treatment duration with G/P, similar to that of patients without severe renal dysfunction, is highly effective for haemodialysis patients with genotype 2 HCV infection, the researchers said.

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