SOFOSBUVIR PLUS VELPATASVIR FOR CHRONIC HCVGENOTYPE 1, 2, 3, AND 4 INFECTION
Author(s): ,
Hussien Ahmed
Affiliations:
Medical Research Group of Egypt,Cairo,Egypt;,Student Research Unit, Zagazig University,Zagazig, El-Sharkia,Egypt;,Faculty of Medicine, Zagazig University,Zagazig, El-Sharkia,Egypt
,
Attia Attia
Affiliations:
Medical Research Group of Egypt,Cairo,Egypt;,Faculty of Medicine, Al Azhar University,Cairo,Egypt
,
Arwa Mohamed
Affiliations:
Medical Research Group of Egypt,Cairo,Egypt;,Faculty of Medicine, Zagazig University,Zagazig, El-Sharkia,Egypt
,
Ahmed Elgebaly
Affiliations:
Medical Research Group of Egypt,Cairo,Egypt;,Faculty of Medicine, Al Azhar University,Cairo,Egypt
Ahmed Negida
Affiliations:
Medical Research Group of Egypt,Cairo,Egypt;,Student Research Unit, Zagazig University,Zagazig, El-Sharkia,Egypt;,Faculty of Medicine, Zagazig University,Zagazig, El-Sharkia,Egypt;,Egyptian Liver Research Institute and Hospital,Mansoura,Egypt
EASL LiverTree™. Negida A. Apr 15, 2016; 125960
Topic: Efficacy
Disclosure(s): I have no conflict of interest to declare.
Dr. Ahmed Negida
Dr. Ahmed Negida

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Abstract
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SAT-104

Topic: Hepatitis C - clinical (therapy)

Background and aims
Hepatitis C virus (HCV) has infected approximately 170 million people worldwide. Sofosbuvir is a direct acting antiviral that inhibits HCV NS5B protein and has been approved to treat HCV in combination with other agents. Velpatasvir is another DAA that inhibits HCV NS5A protein. Recently, multiple studies have evaluated the efficacy of the combination (Sofosbuvir plus Velpatasvir) for the treatment of different HCV genotypes. Therefore, we performed this systematic review and meta-analysis to precisely estimate the sustained virologic response (SVR) achieved by Sofosbuvir plus Velpatasvir for chronic HCV genotype 1, 2, 3, and 4 Infection.

Methods
We followed PRISMA statement guidelines during the preparation of this systematic review and meta-analysis. A computer literature search of PubMed, SCOPUS, web of knowledge, and Cochrane CENTRAL has been conducted using relevant keywords. Studies were screened for eligibility and data were extracted to an online data extraction form. SVR was pooled in a fixed effect model meta-analysis using Mantel–Haenzel method. Heterogeneity was assessed by visual inspection of the forest plots and measured by Chi-square and I-square tests. Statistical analysis was performed by OpenMeta[Analyst] software (by Center of Evidence Based Medicine http://www.cebm.brown.edu/open_meta/).

Results
Five randomized controlled trials (n=2407 patients) were pooled in the final analysis. For non-cirrhotic patients who received 400 mg Sofosbuvir plus 100 mg Velpatasvir, SVR was 97.1% with 95% CI [92.7% to 101.5%].For cirrhotic patients who received 400 mg Sofosbuvir plus 100 mg Velpatasvir, SVR were as follows (for genotype 1a, SVR=97.8% with 95% CI [96.1% to 99.4%]; for genotype 1b, SVR=99% with 95% CI [97.4% to 100%]; for genotype 2, SVR=99.4% with 95% CI [98.4% to 100%]; for genotype 3, SVR=64% with 95% CI [85.8% to 69.1%]; and for genotype 4, SVR=99.7% with 95% CI [98.9% to 100%]).When Ribavirin was added to the treatment regimen, patients with genotype 1a showed less SVR (95.3% vs. 97.8%) while patients with genotype 3 achieved better SVR than without Ribavirin (94.7% vs. 64%).

Conclusions
The treatment regimen of 400 mg Sofosbuvir plus 100 mg Velpatasvir was effective (SVR>95%) for genotype 1, 2, and 4 HCV infection. But for genotype 3, Sofosbuvir plus Velpatasvir showed moderate SVR which improved with adding Ribavirin (64% vs. 94.7%).

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