Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection: Results of a single-center VA experience

Seth N. Sclair, Maria Del Pilar Hernandez, Evan Vance, Dani Gilinski, Helen Youtseff, Maribel Toro, Marie Antoine, Lennox J Jeffers, Adam Peyton

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Treatment of chronic hepatitis C virus (HCV) infection remains a priority in the veterans affairs (VA) health care system nationwide, as there is a high burden of liver disease due to HCV infection among US veterans. The combination of sofosbuvir and simeprevir was the first all-oral antiviral regimen used in clinical practice to treat veterans with HCV infection. In this study, we report a single-center experience showing both the feasibility and effectiveness of this all-oral combination to treat HCV genotype 1 infection. One hundred patients with HCV genotype 1 infection were treated between December 2013 and June 2014. Eighty-six patients were treated with sofosbuvir and simeprevir, with or without ribavirin, for 12 weeks; 12 patients were treated with sofosbuvir, pegylated interferon, and ribavirin for 12 weeks; and 2 patients were treated with sofosbuvir and ribavirin for 24 weeks. Overall, treatment was well tolerated and feasible, with compliance rates over 95% in patients treated with all-oral therapy. The sustained virologic response (SVR) rate for sofosbuvir and simeprevir (88.4%) was superior to the rate for sofosbuvir, pegylated interferon, and ribavirin (50.0%). Subgroup analysis showed diminished SVR rates in cirrhotic patients vs noncirrhotic patients. There were no significant differences in SVR when comparing treatment with or without ribavirin or among genotype subtypes. In conclusion, this study demonstrated excellent completion rates for all-oral treatment of veterans with chronic HCV infection. Additionally, treatment was highly effective, nearing a 90% cure rate. Thus, we recommend that the VA health care system continue to incorporate new HCV medications into its formulary so as to expand HCV treatment for US veterans.

Original languageEnglish (US)
Pages (from-to)490-497
Number of pages8
JournalGastroenterology and Hepatology
Volume12
Issue number8
StatePublished - Aug 1 2016

Fingerprint

Veterans
Hepacivirus
Genotype
Ribavirin
Virus Diseases
Infection
Veterans Health
Chronic Hepatitis C
Therapeutics
Interferons
Delivery of Health Care
Formularies
Sofosbuvir
Simeprevir
Antiviral Agents
Liver Diseases
Sustained Virologic Response

Keywords

  • Direct-acting antiviral agents
  • Hepatitis C virus
  • Ribavirin
  • Simeprevir
  • Sofosbuvir

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Sclair, S. N., Del Pilar Hernandez, M., Vance, E., Gilinski, D., Youtseff, H., Toro, M., ... Peyton, A. (2016). Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection: Results of a single-center VA experience. Gastroenterology and Hepatology, 12(8), 490-497.

Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection : Results of a single-center VA experience. / Sclair, Seth N.; Del Pilar Hernandez, Maria; Vance, Evan; Gilinski, Dani; Youtseff, Helen; Toro, Maribel; Antoine, Marie; Jeffers, Lennox J; Peyton, Adam.

In: Gastroenterology and Hepatology, Vol. 12, No. 8, 01.08.2016, p. 490-497.

Research output: Contribution to journalArticle

Sclair, SN, Del Pilar Hernandez, M, Vance, E, Gilinski, D, Youtseff, H, Toro, M, Antoine, M, Jeffers, LJ & Peyton, A 2016, 'Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection: Results of a single-center VA experience', Gastroenterology and Hepatology, vol. 12, no. 8, pp. 490-497.
Sclair SN, Del Pilar Hernandez M, Vance E, Gilinski D, Youtseff H, Toro M et al. Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection: Results of a single-center VA experience. Gastroenterology and Hepatology. 2016 Aug 1;12(8):490-497.
Sclair, Seth N. ; Del Pilar Hernandez, Maria ; Vance, Evan ; Gilinski, Dani ; Youtseff, Helen ; Toro, Maribel ; Antoine, Marie ; Jeffers, Lennox J ; Peyton, Adam. / Sofosbuvir and simeprevir combination therapy for HCV genotype 1 infection : Results of a single-center VA experience. In: Gastroenterology and Hepatology. 2016 ; Vol. 12, No. 8. pp. 490-497.
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abstract = "Treatment of chronic hepatitis C virus (HCV) infection remains a priority in the veterans affairs (VA) health care system nationwide, as there is a high burden of liver disease due to HCV infection among US veterans. The combination of sofosbuvir and simeprevir was the first all-oral antiviral regimen used in clinical practice to treat veterans with HCV infection. In this study, we report a single-center experience showing both the feasibility and effectiveness of this all-oral combination to treat HCV genotype 1 infection. One hundred patients with HCV genotype 1 infection were treated between December 2013 and June 2014. Eighty-six patients were treated with sofosbuvir and simeprevir, with or without ribavirin, for 12 weeks; 12 patients were treated with sofosbuvir, pegylated interferon, and ribavirin for 12 weeks; and 2 patients were treated with sofosbuvir and ribavirin for 24 weeks. Overall, treatment was well tolerated and feasible, with compliance rates over 95{\%} in patients treated with all-oral therapy. The sustained virologic response (SVR) rate for sofosbuvir and simeprevir (88.4{\%}) was superior to the rate for sofosbuvir, pegylated interferon, and ribavirin (50.0{\%}). Subgroup analysis showed diminished SVR rates in cirrhotic patients vs noncirrhotic patients. There were no significant differences in SVR when comparing treatment with or without ribavirin or among genotype subtypes. In conclusion, this study demonstrated excellent completion rates for all-oral treatment of veterans with chronic HCV infection. Additionally, treatment was highly effective, nearing a 90{\%} cure rate. Thus, we recommend that the VA health care system continue to incorporate new HCV medications into its formulary so as to expand HCV treatment for US veterans.",
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