4CPS-090 Efficacy and safety of pangenotypic treatments in hepatitis C virus (HCV) patients

Background and importanceHepatitis C virus (HCV) is one of the leading causes of progressive liver damage, cirrhosis and hepatocellular carcinoma. The emergence of pangenotypic regimens presents new opportunities for HCV treatments, regardless of genotype, minimising the need for virological testing services.Aim and objectivesTo describe the use of different pangenotypic treatments in HCV patients to evaluate efficacy and safety.Material and methodsObservational and retrospective study in all adult HCV patients who received treatment with pangenotypic treatments between January and December 2020 in a regional hospital of 300 beds. Hospital pharmacist-dispensed treatment monitoring adherence and tolerance. Data collected were age, sex, genotype, degree of fibrosis, type of patients (naïve, relapse or non-respondent), HCV treatment, treatment duration, basal viral load (VL), VL at 12 weeks after treatment completion and adverse reactions. As an indicator of efficacy, sustained viral response (SVR) was used.Results42 patients (76.9% men) were analysed. Median age 50.8 (range 27–79) years. A patient (2.4%) had genotype 1a, 2 (4.8%) had genotype 1b, 5 (11.9%) had genotype 2, 1 (2.4%) had genotype 3, 3 (7.1%) had genotype 4, 1 (2.4%) had genotype 5 and the genotype was not determined in 29 patients (69%). Regarding the degree of fibrosis, 17 patients (40.5%) were F0-F1, 6 (14.3%) were F2, 5 (11.9%) were F3 and 14 (33.3%) were F4. 34 (80.9%) were naïve patients, 5 (11.9%) failed prior treatment based on interferon and 3 (7.1%) were non-responders to treatment with direct-acting antivirals (DAA). 15 patients (35.7%) were treated with glecaprevir/pibrentasvir for 8 weeks, 24 patients (57.1%) with sofosbuvir/velpatasvir for 12 weeks and 3 (7.1%) with sofosbuvir/velpatasvir/voxilaprevir for 12 weeks. Median baseline VL was 3 125 159.6 IU/mL (range 3130–55 800 000), with 22 patients (52.4%) having >800 000 UI/mL. SVR was achieved in 38 patients (90.5%). VL was not determined in 3 patients. Regarding safety, 6 patients (14.3%) suffered at least one adverse reaction: headache (3), fatigue (2), gastrointestinal discomfort (2) and insomnia (1).Conclusion and relevancePangenotypic regimens probably represent the latest stage of development of treatment for chronic hepatitis C, and they have extremely high efficacy regardless of genotype, subtype, treatment history, or fibrosis status. They are well-tolerated drugs with a good safety profile.References and/or acknowledgemen