CP-216 Factors influencing the selection of direct acting antivirals in the treatment of genotype 1 hepatitis C virus infection

• Published in: European journal of hospital pharmacy. Science and practice Vol. 23; no. Suppl 1; pp. A95 - A96
• Main Authors: García-Paricio, R, González-Colominas, E, Echeverría-Esnal, D, Conde-Estevez, D, De Antonio-Cuscó, M, Ferrandez, O, Carrión, JA, Salas, E, Luque, S
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.03.2016
• Subjects: Genotype & phenotype; Hepatitis C; HIV; Human immunodeficiency virus; Liver cirrhosis; Liver diseases; Polypharmacy
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2016-000875.216

BackgroundThe recent approval of the new direct acting antivirals (DAAs) has extended treatment options in hepatitis C virus (HCV) genotype 1 infected patients with compensated liver disease.PurposeTo evaluate which factors can influence the selection of DAAs in genotype 1 HCV patients in our setting.Material and methodsRetrospective study including genotype 1 HCV patients treated with interferon free DAAs from December 2014 to September 2015. Data collected: demographics, genotype 1 subtype, HIV infection, presence of liver cirrhosis (LC), prior treatment status (naïve or pretreated) and other concomitant drugs. DAAs were classified­ as follows: sofosbuvir+simeprevir±ribavirin (SOF/SMV); sofosbuvir+daclatasvir±ribavirin (SOF/DCV); sofosbuvir/ledipasvir±ribavirin (SOF/LDV); ombitasvir/paritaprevir/ritonavir+dasabuvir±RBV (OBV/PTV/r/DSV). The χ2 test and the Mann-Whitney U test were used for categorical and quantitative variables, respectively.ResultsWe included 124 patients: 79 (63.7%) male; mean age 60.8 (±SD 11.5) years; 35 (28.2%) genotype 1a; 26 (21%) HIV/HCV coinfected; 79 (63.7%) LC; 65 (52.4%) naïve; and 56 (45.2%) with polypharmacy (>3 drugs, median value).DAA regimen selected: 34 (27.4%) SOF/SMV; 14 (11.3%) SOF/DCV; 34 (27.4%) SOF/LDV and 42 (33.9%) OBV/PTV/r/DSV. There were statistically significant differences in the frequency distribution of the different selected DAAs (table 1)Abstract CP-216 Table 1Differential factorSOF/SMVSOF/DCVSOF/LDVOBV/PTV/r/DSVLiver cirrhosis (n (%))LC19 (24.1)11 (13.9)27 (34.2)22 (27.8)No LC15 (33.3)3 (6.7)7 (15.6)20 (44.4)HIV coinfection (n (%))HIV6 (23.1)6 (23.1)10 (38.5)4 (15.4)No HIV28 (28.6)8 (8.2)24 (24.5)38 (38.8)Prior treatment (n (%))Naïve14 (21.5)4 (6.2)18 (27.7)29 (44.6)Pretreated20 (33.9)10 (16.9)16 (27.1)13 (22)A tendency was observed when comparing different genotype subtypes (p = 0.094) or presence of polypharmacy (p = 0.088).ConclusionHIV/HCV coinfected and cirrhotic patients were more likely to be treated with SOF/LDV while HCV monoinfected and non-cirrhotic patients with likely to receive OBV/PTV/r/DSV. Pretreated patients were more likely to be treated with SOF/SMV while those naïve with more likely to receive OBV/PTV/r/DSV.The major potential for drug-drug interactions of OBV/PTV/r/DSV and its lower experience in advanced liver disease and previous triple therapy failure could have influenced these findings.References and/or AcknowledgementsPawlotsky JM. EASL Recommendations on Treatment of Hepatitis C 2015. J Hepatol 2015No conflict of interest.