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Treatment of chronic genotype-3 hepatitis C virus infection using direct-acting antiviral agents: An Indian experience

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Abstract

Background

Direct-acting antiviral drugs (DAAs) are favored for the treatment of hepatitis C virus (HCV) infection. However, the experience with the DAAs currently available in India in the treatment of genotype-3 HCV is limited. We therefore reviewed our experience with these drugs in treating patients with chronic genotype-3 HCV infection, including those with cirrhosis.

Methods

We prospectively followed adult patients with genotype-3 HCV infection who had received treatment regimens containing sofosbuvir with/without daclatasvir. Patients were categorized as chronic hepatitis C (CHC), compensated cirrhosis (CC), and decompensated cirrhosis (DC). They received either (i) sofosbuvir and ribavirin, with or without pegylated interferon (Peg-IFN) for 12 or 24 weeks, or (ii) sofosbuvir and daclatasvir, with or without ribavirin for 12 or 24 weeks. Response was assessed using HCV RNA testing after 2 or 4 weeks of treatment (rapid virological response [RVR]), at treatment completion (end-of-treatment response [ETR]) or 12 weeks after treatment completion (sustained virological response [SVR12]).

Results

Of the 160 patients (90% treatment-naïve; CHC 49%, CC 32%, and DC 19%), 39 (24%) received Peg-IFN, sofosbuvir and ribavirin, 21 (13%) received sofosbuvir and ribavirin, and 100 (63%) received sofosbuvir and daclatasvir, with or without ribavirin. On intention-to-treat basis, RVR, ETR, and SVR12 in the entire cohort were 146/160 (91.3%), 151/160 (94.4%), and 147/160 (91.9%), respectively. Seven patients died (CC 2, DC 5) during treatment; four (2 CHC, 2 DC) patients discontinued treatment; and two patients with CC relapsed.

Conclusions

Dual-DAA-based regimens were safe and highly effective in treating genotype-3 HCV infection in CHC and CC patients.

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Author notes

  1. Amit Goel and Rajat Bhargava have contributed equally and share the first authorship

Authors and Affiliations

  1. Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226 014, India

    Amit Goel, Rajat Bhargava, Praveer Rai & Rakesh Aggarwal

Authors
  1. Amit Goel
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  2. Rajat Bhargava
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  3. Praveer Rai
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  4. Rakesh Aggarwal
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Corresponding author

Correspondence to Rakesh Aggarwal.

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AG, RB, PR, and RA declare that they have no conflict of interest.

Ethics statement

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Goel, A., Bhargava, R., Rai, P. et al. Treatment of chronic genotype-3 hepatitis C virus infection using direct-acting antiviral agents: An Indian experience. Indian J Gastroenterol 36, 227–234 (2017). https://doi.org/10.1007/s12664-017-0763-3

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  • DOI: https://doi.org/10.1007/s12664-017-0763-3

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