Sofosbuvir plus ledipasvir shows promise in re-treating even the sickest patients after HVC GT-1 relapse
Relapse of chronic hepatitis C virus (HVC) genotype 1 (GT-1) after initial treatment with sofosbuvir plus ribavirin therapy can be effectively re-treated with a combination of sofosbuvir plus ledipasvir according to an open-label pilot study being published in Annals of Internal Medicine.
Recently, the U.S. Food and Drug Administration approved sofosbuvir plus ribavirin as a treatment for HCV GT-1 in patients who are not eligible for first-line treatment with pegylated interferon (IFN) and ribavirin. Although well-tolerated and effective, patients with advanced liver disease and transplant recipients taking the IFN-free regimen have a modest rate of relapse. Sofosburvir combined with ledipasvir for 12 weeks showed high sustained virologic response (SVR) rates in treatment-naïve patients with HVC GT-1.
Researchers sought to determine if this combination would be safe and effective for patients that relapsed after sofosbuvir plus ribavirin therapy. Fourteen patients (half of whom had advanced liver disease) with HCV GT-1 that relapsed after treatment with sofosbuvir plus ribavirin for 24 weeks were re-treated with sofosbuvir plus ledipasvir. After 12 weeks, all patients achieved SVR with no serious adverse events. The researchers suggest that the low incidence of adverse events, low pill burden, shorter treatment duration, and high efficacy may make the sofosbuvir/ledipasvir combination attractive in real-world settings.
Article: Re-treatment of Chronic Hepatitis C Virus Genotype 1 Infection After Relapse: An Open- Label Pilot Study, A. Osinusi, A. Kohli, M.M. Marti, A. Nelson, X. Zhang, E.G. Meissner, R. Silk, K. Townsend, P.S. Pang, G.M. Subramanian, J.G. McHutchison, A.S. Fauci, H. Masur, and S. Kottilil, Annals of Internal Medicine, published 3 November 2014.
Source: American College of Physicians