Paritaprevir/ritonavir, ombitasvir, and dasabuvir (PrOD) with or without ribavirin is highly effective for treating patients with chronic hepatitis C with advanced hepatic fibrosis or compensated cirrhosis, according to the results of a large retrospective cohort study published in Scientific Reports.1

Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, which can lead to progressive hepatic fibrosis and cirrhosis in approximately 20% of patients; 10% to 20% of patients with cirrhosis will then develop hepatocellular carcinoma within 5 years.2-4 PrOD-based regimens for HCV-1 infection have demonstrated favorable results in terms of efficacy and safety, yet real-world data remain limited from patients with advanced hepatic fibrosis (fibrosis 3, F3) or compensated cirrhosis (F4) in Asian populations.1 Therefore, researchers in Taiwan conducted a study to evaluate the safety and efficacy of PrOD-based therapies in a large real-world cohort of 941 patients with HCV and advanced hepatic fibrosis or compensated cirrhosis. Patients with HCV-1b received 12 weeks of PrOD and patients with HCV-1a without or with cirrhosis received 12 or 24 weeks of PrOD plus ribavirin therapy.

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The researchers found that the overall sustained virologic response 12 weeks off therapy rate was 98.8% in patients with HCV-1b, 100% in patients with HCV-1a without cirrhosis, and 96.4% in patients with HCV-1a with cirrhosis. They also found that the Child-Pugh A6 was the only significant factor of poor sustained virologic response 12 weeks off therapy and predicted hepatic decompensation during PrOD-based therapies; therefore it should be an exclusion criterion for first-line treatment in these patients.

“In conclusion, this large real-world cohort proved PrOD with or without ribavirin to be highly effective in chronic hepatitis C patients with advanced hepatic fibrosis or compensated cirrhosis,” stated the investigators.1

References

1. Chen C-H, Chen C-H, Lin C-L, et al. Real-world safety and efficacy of paritaprevir/ritonavir/ombitasvir plus dasabuvir±ribavirin in patients with hepatitis C virus genotype 1 and advanced hepatic fibrosis or compensated cirrhosis: a multicenter pooled analysis. Sci Rep. 2019;9(1):7086.

2. World Health Organization. Hepatitis C [July 18, 2018]. www.who.int/news-room/fact-sheets/detail/hepatitis-c. Accessed May 24, 2018.

3. Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61:S45-S57.

4. Hoshida Y, Fuchs BC, Bardeesy N, Baumert TF, Chung RT. Pathogenesis and prevention of hepatitis C virus-induced hepatocellular carcinoma. J Hepatol. 2014;61:S79-S90.