Regimens for chronic infection Gt 2 HCV

Sofosbuvir plus velpatasvir

The combination of sofosbuvir plus velpatasvir is a safe and effective treatment for Gt 2 HCV (see Section Sofosbuvir and Velpatasvir and Table 4).

The recommended treatment duration is 12 weeks for all patients. Cure rates > 95% were observed in clinical trials, including among people with cirrhosis.31 This is now the recommended regimen for treating patients with Gt 2 HCV.

 

Sofosbuvir plus ribavirin

The combination of sofosbuvir plus ribavirin for 12 weeks is now considered a second-line regimen for Gt 2 HCV, given concerns about lower efficacy in people with cirrhosis and the potential for ribavirin-related toxicity. Sofosbuvir plus ribavirin was the first IFN-free treatment regimen for Gt 2 HCV available for prescription under the PBS (Table 4). This regimen is highly effective in people with no cirrhosis, with overall cure rates of 90%–95%.49-52 In people with cirrhosis, lower SVR rates have been observed. Treatment extension may increase SVR rates in people with cirrhosis. Evidence for this comes from data for treatment-experienced people with Gt 2 HCV and cirrhosis, in whom treatment extension from 12 to 16 weeks improved SVR rates from 60% to 78%.50 A subsequent study in the same population demonstrated a non-significant trend for higher SVR rates with treatment extension to 24 weeks (16 v 24 weeks: SVR, 87% v 100%).52 Note that treatment duration for longer than 12 weeks is not currently available under the PBS. Treatment is generally well tolerated, but with the adverse event profile typical for ribavirin.

Tags: CCK

PrintEmail