PMID- 33978973 OWN - NLM STAT- MEDLINE DCOM- 20220105 LR - 20220105 IS - 1440-1746 (Electronic) IS - 0815-9319 (Linking) VI - 36 IP - 10 DP - 2021 Oct TI - Pangenotypic direct-acting antiviral agents for mixed genotype hepatitis C infection: A real-world effectiveness analysis. PG - 2911-2916 LID - 10.1111/jgh.15546 [doi] AB - BACKGROUND: Pangenotypic direct-acting antiviral agents (DAAs) glecaprevir/pibrentasvir (GLE/PIB) and sofosbuvir/velpatasvir (SOF/VEL) are effective against all hepatitis C virus (HCV) genotype infections. However, data on pangenotypic DAA treatment for mixed genotype HCV infection are sparse. METHODS: This is a retrospective, single site cohort study analyzing all patients with mixed HCV genotype infections treated with GLE/PIB or SOF/VEL from August 2018 to August 2020 in Chiayi Chang Gung Memorial Hospital, Taiwan. The primary study endpoint was sustained virologic response (SVR) 12 weeks after treatment cessation. We also reported adverse events (AEs). RESULTS: A total of 108 patients with mixed infections of any two or three genotypes of 1a, 1b, 2, 3, and 6 received pangenotypic DAAs during the study period. A total of 67 patients received GLE/PIB and 41 received SOF/VEL. The evaluable population analysis revealed SVR rates of 94% (63/67) and 95.1% (39/41) for GLE/PIB and SOF/VEL therapy, respectively, and the per-protocol analysis revealed an SVR of 100% for both regimens. Four patients in the GLE/PIB group and two patients in the SOF/VEL were lost to follow-up. The most common AEs for GLE/PIB versus SOF/VEL therapy included pruritus (14.9% vs 2.4%), fatigue (6.0% vs 7.3%), abdominal discomfort (4.5% vs 7.3%), and acid reflux (3.0% vs 4.9%). DAA-related significant laboratory abnormalities occurred in three patients with > 1.5 x elevated bilirubin level in the GLE/PIB group. None of the above AEs resulted in DAA discontinuation. CONCLUSIONS: Pangenotypic DAAs are well tolerated by and yield high SVR rates in patients with mixed genotype HCV infection. CI - (c) 2021 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. FAU - Ding, Yuan-Jie AU - Ding YJ AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Lu, Chung-Kuang AU - Lu CK AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Chen, Wei-Ming AU - Chen WM AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Tung, Shui-Yi AU - Tung SY AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Wei, Kuo-Liang AU - Wei KL AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Shen, Chen-Heng AU - Shen CH AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Hsieh, Yung-Yu AU - Hsieh YY AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Yen, Chih-Wei AU - Yen CW AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Chang, Kao-Chi AU - Chang KC AUID- ORCID: 0000-0002-0185-2286 AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Chiu, Wen-Nan AU - Chiu WN AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Hung, Chao-Hung AU - Hung CH AUID- ORCID: 0000-0003-1646-9519 AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. FAU - Lu, Sheng-Nan AU - Lu SN AUID- ORCID: 0000-0002-5493-4752 AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. FAU - Chang, Te-Sheng AU - Chang TS AUID- ORCID: 0000-0002-1581-6948 AD - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan, Taiwan. LA - eng GR - CMRPG6J0171/Chang Gung Memorial Hospital/ PT - Journal Article DEP - 20210519 PL - Australia TA - J Gastroenterol Hepatol JT - Journal of gastroenterology and hepatology JID - 8607909 RN - 0 (Antiviral Agents) RN - WJ6CA3ZU8B (Sofosbuvir) SB - IM MH - Antiviral Agents/adverse effects MH - Cohort Studies MH - Genotype MH - Hepacivirus/genetics MH - *Hepatitis C/drug therapy MH - *Hepatitis C, Chronic/drug therapy MH - Humans MH - Retrospective Studies MH - Sofosbuvir/adverse effects MH - Sustained Virologic Response MH - Treatment Outcome OTO - NOTNLM OT - mixed HCV genotype OT - pangenotypic direct-acting antiviral agent OT - sustained virologic response EDAT- 2021/05/13 06:00 MHDA- 2022/01/06 06:00 CRDT- 2021/05/12 12:37 PHST- 2021/05/05 00:00 [revised] PHST- 2021/03/09 00:00 [received] PHST- 2021/05/09 00:00 [accepted] PHST- 2021/05/13 06:00 [pubmed] PHST- 2022/01/06 06:00 [medline] PHST- 2021/05/12 12:37 [entrez] AID - 10.1111/jgh.15546 [doi] PST - ppublish SO - J Gastroenterol Hepatol. 2021 Oct;36(10):2911-2916. doi: 10.1111/jgh.15546. Epub 2021 May 19.