Response Guided Therapy for Reducing Duration of Direct Acting Antivirals in Chronic Hepatitis C Infected Patients: a Pilot Study

Overview

Journal Sci Rep

Specialty Science

Date 2020 Oct 21

PMID 33082372

Citations 15

Authors

Ohad Etzion

Harel Dahari

David Yardeni

Assaf Issachar

Anat Nevo-Shor

Michal Cohen-Naftaly

Yaffa Ashur

Susan L Uprichard

Orly Sneh Arbib

Daniela Munteanu

Marius Braun

Scott J Cotler

Naim Abufreha

Ayelet Keren-Naus

Yonat Shemer-Avni

Orna Mor

Jayanah Murad

Victor Novack

Amir Shlomai

Affiliations

Soon will be listed here.

Abstract

The advent of direct-acting antivirals (DAAs) has transformed the landscape of hepatitis C virus (HCV) management. We aimed to prospectively (real-time) evaluate the feasibility of using a response-guided therapy approach, based on mathematical modeling of early viral kinetics, to reduce the duration of DAAs therapy. Patients were treated with DAAs according to the physicians' preference. HCV was measured at baseline and at day 2 and weeks 1, 2 and 4 after treatment initiation. The primary endpoint was the proportion of patients with sustained-virological response (SVR) at 12 and/or 24 weeks post-treatment. Twenty-nine patients (mean age 54 ± 16, 44% females, 73% with HCV genotype 1), were enrolled and all completed therapy. Treatment duration was shortened in 11 of the 29 patients (38%). SVR was achieved in 28 of the 29 patients (97%). Relapse occurred post treatment in a single case of a non-cirrhotic male with genotype 3, who was treated with sofosbuvir/velpatasvir for 6 weeks. Virus sequencing did not identify baseline or treatment emergent resistance associated substitutions. Real-time mathematical modeling of early HCV kinetics can be utilized for shortening DAAs duration in approximately 40% of patients without compromising treatment efficacy.Clinical trial registration: ClinicalTrials.gov Identifier: NCT03603327.

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