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Sofosbuvir in Co-Infection With Different Genotypes

April 1, 2014

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Sofosbuvir is a nucleotide polymerase inhibitor taken at a dose of 400 mg once daily as part of combination therapy for HCV. When sofosbuvir is used with ribavirin, the dose of ribavirin is often adjusted based on a person's weight.

In a clinical trial called Photon 1, researchers tested different schedules of sofosbuvir + ribavirin in people co-infected with different strains, or genotypes (GT), of HCV. Participants were divided into the following groups:

  • no previous treatment and GT1: 114 participants received treatment for 24 weeks
  • no previous treatment and GT2 or 3: 68 participants received treatment for 12 weeks
  • prior unsuccessful treatment and GT2 or 3: 41 participants received treatment for 24 weeks

The average profile of participants at the time they entered the study was as follows:

  • 80% men, 20% women
  • age: 50 years
  • common HCV genotypes: GT1a, GT2 and GT3
  • 95% of participants were taking ART
  • CD4+ count: 600 cells/ml
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Commonly used anti-HIV drugs included the following:

  • efavirenz
  • atazanavir + ritonavir
  • darunavir + ritonavir
  • raltegravir
  • rilpivirine
  • Truvada


Results

Between 90% and 98% of participants completed the study. Depending on their subgroup and strain of HCV, between 75% and 100% of participants recovered from HCV infection.


Specific Results: GT1

The proportion of participants with an undetectable HCV viral load at different times was as follows:

  • Week 4: 96%
  • end of treatment: 100%
  • sustained virologic response (SVR12) 12 weeks after the end of therapy: 76%
  • sustained virologic response (SVR24) 24 weeks after the end of therapy: 75%

Thus, 75% of participants with GT1 were cured.


Specific Results: GT2 (Who Had No Previous Treatment)

The proportion of participants with an undetectable HCV viral load at different times was as follows:

  • Week 4: 96%
  • end of treatment: 96%
  • sustained virologic response (SVR12) 12 weeks after the end of therapy: 88%
  • sustained virologic response (SVR24) 24 weeks after the end of therapy: 88%

Thus, 88% of participants with GT2 who had no prior therapy were cured.


Specific Results: GT2 Who Had Prior Unsuccessful Therapy

The proportion of participants with an undetectable HCV viral load at different times was as follows:

  • Week 4: 100%
  • end of treatment: 100%
  • sustained virologic response (SVR12) 12 weeks after the end of therapy: 92%
  • sustained virologic response (SVR24) 24 weeks after the end of therapy: 92%

Thus, 92% of GT2 participants who had prior unsuccessful therapy were cured.

One participant became re-infected with HCV during the study.


Specific Results: GT3 (No Prior Therapy)

The proportion of participants with an undetectable HCV viral load at different times was as follows:

  • Week 4: 100%
  • end of treatment: 98%
  • sustained virologic response (SVR12) 12 weeks after the end of therapy: 67%
  • sustained virologic response (SVR24) 24 weeks after the end of therapy: 67%

Thus, 67% of participants with GT3 who had no prior therapy were cured.


Specific Results: GT3 Who Had Unsuccessful Prior Therapy

The proportion of participants with an undetectable HCV viral load at different times was as follows:

  • Week 4: 100%
  • end of treatment: 100%
  • sustained virologic response (SVR12) 12 weeks after the end of therapy: 94%
  • sustained virologic response (SVR24) 24 weeks after the end of therapy: 88%

Thus, 88% of participants who had GT3 and whose prior therapy failed were cured.

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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication TreatmentUpdate. Visit CATIE's Web site to find out more about their activities, publications and services.
 

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