In:
Hepatology Research, Wiley, Vol. 50, No. 11 ( 2020-11), p. 1234-1243
Kurzfassung:
Combination therapy with sofosbuvir (SOF) plus velpatasvir (VEL) is approved for patients with hepatitis C virus (HCV)‐related decompensated cirrhosis. We analyzed the real‐world efficacy of SOF/VEL therapy. Methods Thirty‐three patients with HCV‐related decompensated cirrhosis (25 and eight patients with Child B and C, respectively) were treated with SOF/VEL for 12 weeks. The HCV non‐structural protein (NS)5A and NS5B drug resistance‐associated substitutions (RASs) were determined by direct sequencing. Result Thirty‐two of 33 patients completed the treatment, but the remaining patient discontinued the therapy during third week of the treatment due to aggravation of hepatic encephalopathy. Serum HCV‐RNA became negative during the treatment in all patients but relapsed after the end of therapy in five patients. In total, 28 out of 33 patients (85%) achieved sustained virological response 12 weeks following completion of treatment (SVR12). The SVR12 rate was 96% in patients with Child B, but significantly lower, at 50%, in patients with Child C ( P 〈 0.05). In genotype 1b HCV‐infected patients, all eight patients without baseline NS5A RASs, but only three of seven patients with RASs, achieved SVR12. Multivariate analysis identified Child B (odds ratio, 35.8 for Child C; P = 0.045) as an independent predictor of SVR12. Median serum albumin levels significantly increased only in patients who achieved SVR12. Child–Pugh scores improved in 16 of 28 patients (57%) following achievement of SVR12. Conclusion The effect of SOF/VEL therapy is lower for patients with Child C. Improvement of hepatic function is expected after viral eradication with SOF/VEL therapy in patients with decompensated cirrhosis.
Materialart:
Online-Ressource
ISSN:
1386-6346
,
1872-034X
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2020
ZDB Id:
2006439-1
