Is Ribavirin Really Needed for Patients With HCV Genotype 3 on Sofosbuvir/Velpatasvir?: Presented at Liver Meeting

By Andrew D. Bowser

WASHINGTON, DC -- October 23, 2017 -- In patients with hepatitis C virus (HCV) genotype 3 with cirrhosis, adding ribavirin on top of sofosbuvir/velpatasvir does not appear to improve the chances of treatment success, according to a study presented here at The Liver Meeting, the Annual Meeting of the American Association for the Study of Liver Diseases (AASLD).

The findings add new perspective to the ongoing discussion among researchers and clinicians as to whether adding ribavirin might prevent a relapse in patients with HCV genotype 3, particularly if they were previously treated.

Results of the current study represent “real world” experience with patients with HCV genotype 3 treated at 9 sites in Germany, according to Stefan Christensen, MD, Department of Infectious Diseases, Center for Interdisciplinary Medicine, Muenster, Germany.

“We could confirm the high SVR12 rates [sustained virologic response at 12 weeks] from the clinical phase 3 studies with sofosbuvir/velpatasvir, [but] in our cohort, it seems like the addition of ribavirin in cirrhotic patients did not have further benefit for those patients,” he said.

The results were based on data for 232 patients in the German Hepatitis C Cohort (GECCO) who were treated with sofosbuvir/velpatasvir, with or without ribavirin, for 12 weeks. Most (86%) patients received sofosbuvir/velpatasvir alone and 14% received sofosbuvir/velpatasvir plus ribavirin.

In the per protocol analysis, which included 144 of those patients, the overall rate of SVR12 was 99% (140/141 patients), with similarly high rates of SVR12 in the sofosbuvir/velpatasvir alone group (94%) and the sofosbuvir/velpatasvir plus ribavirin group (100%).

“The data points in the direction that probably, at least in the uncomplicated patients not pretreated with sofosbuvir-[based regimens], you probably don’t need ribavirin,” said Dr. Christensen.

The researchers also looked at SVR12 rates according to baseline NS5A resistance-associated substitutions (RAS), since in previous investigations, they were associated with a higher risk of virologic failure. Data from per protocol analysis showed SVR12 rates of 99% (98/99 patients) with no RAS, and 100% (10/10 patients) with RAS, leading investigators to conclude that RAS “did not influence the chance for SVR12.”

[Presentation Title: Do Resistance Associated Substitutions (RAS) or Ribavirin (RBV) Use Influence Treatment Success of Sofosbuvir (SOF)/Velpatasvir (VEL) in Chronic Hepatitis C Genotype 3 (GT 3) Infection? - Results From the German Hepatitis C Cohort (GECCO). Abstract 63]

To read more Conference Dispatch articles, click here.