Publication: High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis with 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study
Issued Date
2021-07-01
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ISSN
23288957
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2-s2.0-85112511379
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Mahidol University
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SCOPUS
Bibliographic Citation
Open Forum Infectious Diseases. Vol.8, No.7 (2021)
Suggested Citation
Barnaby Flower, Leanne McCabe, Chau Le Ngoc, Hung Le Manh, Phuong Le Thanh, Thuan Dang Trong, Thu Vo Thi, Hang Vu Thi Kim, Thanh Nguyen Tat, Dao Phan Thi Hong, An Nguyen Thi Chau, Tan Dinh Thi, Nga Tran Thi Tuyet, Joel Tarning, Cherry Kingsley, Evelyne Kestelyn, Sarah L. Pett, Guy Thwaites, Vinh Chau Nguyen Van, David Smith, Eleanor Barnes, M. Azim Ansari, Hugo Turner, Motiur Rahman, Ann Sarah Walker, Jeremy Day, Graham S. Cooke High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis with 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study. Open Forum Infectious Diseases. Vol.8, No.7 (2021). doi:10.1093/ofid/ofab267 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78053
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Title
High Cure Rates for Hepatitis C Virus Genotype 6 in Advanced Liver Fibrosis with 12 Weeks Sofosbuvir and Daclatasvir: The Vietnam SEARCH Study
Author(s)
Barnaby Flower
Leanne McCabe
Chau Le Ngoc
Hung Le Manh
Phuong Le Thanh
Thuan Dang Trong
Thu Vo Thi
Hang Vu Thi Kim
Thanh Nguyen Tat
Dao Phan Thi Hong
An Nguyen Thi Chau
Tan Dinh Thi
Nga Tran Thi Tuyet
Joel Tarning
Cherry Kingsley
Evelyne Kestelyn
Sarah L. Pett
Guy Thwaites
Vinh Chau Nguyen Van
David Smith
Eleanor Barnes
M. Azim Ansari
Hugo Turner
Motiur Rahman
Ann Sarah Walker
Jeremy Day
Graham S. Cooke
Leanne McCabe
Chau Le Ngoc
Hung Le Manh
Phuong Le Thanh
Thuan Dang Trong
Thu Vo Thi
Hang Vu Thi Kim
Thanh Nguyen Tat
Dao Phan Thi Hong
An Nguyen Thi Chau
Tan Dinh Thi
Nga Tran Thi Tuyet
Joel Tarning
Cherry Kingsley
Evelyne Kestelyn
Sarah L. Pett
Guy Thwaites
Vinh Chau Nguyen Van
David Smith
Eleanor Barnes
M. Azim Ansari
Hugo Turner
Motiur Rahman
Ann Sarah Walker
Jeremy Day
Graham S. Cooke
Abstract
Background: Genotype 6 is the most genetically diverse lineage of hepatitis C virus, and it predominates in Vietnam. It can be treated with sofosbuvir with daclatasvir (SOF/DCV), the least expensive treatment combination globally. In regional guidelines, longer treatment durations of SOF/DCV (24 weeks) are recommended for cirrhotic individuals, compared with other pangenotypic regimens (12 weeks), based on sparse data. Early on-treatment virological response may offer means of reducing length and cost of therapy in patients with liver fibrosis. Methods: In this prospective trial in Vietnam, genotype 6-infected adults with advanced liver fibrosis or compensated cirrhosis were treated with SOF/DCV. Day 14 viral load was used to guide duration of therapy: participants with viral load <500 IU/mL at day 14 were treated with 12 weeks of SOF/DCV and those ≥500 IU/mL received 24 weeks. Primary endpoint was sustained virological response (SVR). Results: Of 41 individuals with advanced fibrosis or compensated cirrhosis who commenced treatment, 51% had genotype 6a and 34% had 6e. The remainder had 6h, 6k, 6l, or 6o. One hundred percent had viral load <500 IU/mL by day 14, meaning that all received 12 weeks of SOF/DCV. One hundred percent achieved SVR12 despite a high frequency of putative NS5A inhibitor resistance-associated substitutions at baseline. Conclusions: Prescribing 12 weeks of SOF/DCV results in excellent cure rates in this population. These data support the removal of costly genotyping in countries where genotype 3 prevalence is <5%, in keeping with World Health Organization guidelines. NS5A resistance-associated mutations in isolation do not affect efficacy of SOF/DCV therapy. Wider evaluation of response-guided therapy is warranted.