RT Journal Article
T1 Effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir in patients with chronic hepatitis C previously treated with DAAs.
A1 Llaneras, Jordi
A1 Riveiro-Barciela, Mar
A1 Lens, Sabela
A1 Diago, Moisés
A1 Cachero, Alba
A1 García-Samaniego, Javier
A1 Conde, Isabel
A1 Arencibia, Ana
A1 Arenas, Juan
A1 Gea, Francisco
A1 Torras, Xavier
A1 Luis Calleja, José
A1 Antonio Carrión, José
A1 Fernández, Inmaculada
A1 María Morillas, Rosa
A1 Rosales, José Miguel
A1 Carmona, Isabel
A1 Fernández-Rodríguez, Conrado
A1 Hernández-Guerra, Manuel
A1 Llerena, Susana
A1 Bernal, Vanesa
A1 Turnes, Juan
A1 González-Santiago, Jesús M
A1 Montoliu, Silvia
A1 Figueruela, Blanca
A1 Badia, Ester
A1 Delgado, Manuel
A1 Fernández-Bermejo, Miguel
A1 Iñarrairaegui, Mercedes
A1 Pascasio, Juan Manuel
A1 Esteban, Rafael
A1 Mariño, Zoe
A1 Buti, Maria
K1 HCV genotype 3
K1 Hepatitis C
K1 Sofosbuvir
K1 Treatment failures
K1 Velpatasvir
K1 Voxilaprevir
AB Around 5% of patients with chronic hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents do not achieve sustained virological response (SVR). The currently approved retreatment regimen for prior DAA failure is a combination of sofosbuvir, velpatasvir, and voxilaprevir (SOF/VEL/VOX), although there is little data on its use in clinical practice. The aim of this study was to analyse the effectiveness and safety of SOF/VEL/VOX in the real-world setting. This was a prospective multicentre study assessing the efficacy of retreatment with SOF/VEL/VOX in patients who had experienced a prior DAA treatment failure. The primary endpoint was SVR 12 weeks after the completion of treatment (SVR12). Data on safety and tolerability were also recorded. A total of 137 patients were included: 75% men, 35% with liver cirrhosis. Most were infected with HCV genotype (GT) 1 or 3. The most common prior DAA combinations were sofosbuvir plus an NS5A inhibitor or ombitasvir/paritaprevir/r+dasabuvir. A total of 136 (99%) patients achieved undetectable HCV RNA at the end of treatment. Overall SVR12 was 95% in the 135 patients reaching this point. SVR12 was lower in patients with cirrhosis (89%, p = 0.05) and those with GT3 infection (80%, p  Real-world data show that SOF/VEL/VOX is an effective, safe rescue therapy for patients with prior DAA treatment failure despite the presence of resistance-associated substitutions. However, patients with liver cirrhosis infected by GT3 remain the most-difficult-to-treat group. Treatment with sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for 12 weeks is the current recommendation for the 5% of patients infected with HCV who do not achieve eradication of the virus under treatment with direct-acting antivirals. In a Spanish cohort of 137 patients who failed a previous combination of direct-acting antivirals, a cure rate of 95% was achieved with SOF/VEL/VOX. Genotypic characteristics of the virus (genotype 3) and the presence of cirrhosis were factors that decreased the rate of cure. Treatment with SOF/VEL/VOX is an effective and safe rescue therapy due to its high efficacy and very good safety profile.
YR 2019
FD 2019-06-14
LK http://hdl.handle.net/10668/14121
UL http://hdl.handle.net/10668/14121
LA en
DS RISalud
RD May 9, 2025