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Glecaprevir plus pibrentasvir highly effective in previously treated HCV infection

15 Mar 2019

Combination treatment with glecaprevir (GLE) plus pibrentasvir (PIB) produces a sustained virological response (SVR) in more than 90 percent of hepatitis C virus (HCV)-infected patients who previously failed direct-acting antiviral (DAA) treatments, regardless of liver fibrosis stage, a study has shown.

A total of 30 patients infected with HCV genotype 1b, 2a, 2b or 3a who showed no response to prior DAA therapies received GLE/PIB for 12 weeks. Researchers used direct sequencing analysis to identify HCV NS3 and NS5A drug resistance-associated variants (RAVs).

SVR at 12 weeks after the end of treatment (SVR12) occurred in 28 patients (93.3 percent), and the rates did not significantly differ between patients with and without advanced liver fibrosis (94.7 percent and 91.0 percent, respectively).

All nine patients with HCV genotype 2a, 2b or 3a infection achieved SVR12. On the other hand, two genotype 1b-infected patients who failed previous therapy with daclatasvir plus asunaprevir had HCV relapse after completion of GLE/PIB treatment.

Direct sequence analysis revealed the presence of NS3-D168E plus NS5A-L31I/P58S/Y93H RAVs in one patient and NS5A-L31F/P32del RAVs in another patient prior to GLE/PIB treatment. NS3-D168E plus NS5A-L31I/P58S/Y93H RAVs persisted in the former patient, with additional NS5A-L28M/V75A variants emerging after HCV relapse.

The findings indicate that the GLE plus PIB combination is an effective pan-genotypic rescue treatment for HCV, researchers said. More studies enrolling a larger number of patients are required to elucidate the relationship between the efficacy of the combination and HCV genotypes.

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