Short-duration treatment with elbasvir/grazoprevir and sofosbuvir for hepatitis C: A randomized trial

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Direct-acting antiviral agents (DAAs) are standard for hepatitis C virus (HCV) infection.
• Combining DAAs with different mechanisms may shorten treatment duration.
• Identifying minimum effective treatment duration across genotypes is crucial.

Purpose of the Study:

• To determine the minimum effective treatment duration for HCV genotypes 1 and 3 using a specific DAA combination.
• To evaluate treatment efficacy and safety in treatment-naïve patients.

Main Methods:

• Open-label, single-center trial (C-SWIFT) involving treatment-naïve patients with chronic HCV GT1 or 3.
• Patients received elbasvir (EBR) 50 mg/grazoprevir (GZR) 100 mg with sofosbuvir (SOF) 400 mg for 4-12 weeks.
• Sustained virological response (SVR)12 was the primary endpoint; retreatment was offered for treatment failures.

Main Results:

• High SVR12 rates were observed with 8-week regimens, even for HCV GT3 patients.
• For GT1 patients without cirrhosis, 6-week treatment yielded 87% SVR12.
• For GT3 patients without cirrhosis, 8-week treatment achieved 93% SVR12, and 12-week treatment achieved 100% SVR12.

Conclusions:

• An 8-week treatment regimen with EBR/GZR+SOF demonstrates high efficacy for HCV GT1 and GT3 infections.
• Retreatment for treatment failures involved extended duration and ribavirin, achieving SVR12 in all patients.
• The findings support shorter, effective treatment durations for HCV infection.