Short Course Therapy With Glecaprevir/Pibrentasvir for Early Hepatitis C Virus Infection: PURGE-C

Area of Science:

• Hepatology
• Virology
• Infectious Diseases

Background:

• Shorter treatment regimens for early hepatitis C virus (HCV) infection can streamline care, especially for key populations.
• The PURGE-C trial (A5380) investigated a 4-week glecaprevir/pibrentasvir (G/P) regimen for early HCV.
• Early HCV was defined by detectable HCV RNA or elevated ALT within 24 weeks of enrollment.

Purpose of the Study:

• To evaluate the efficacy of a 4-week G/P treatment course for early HCV infection.
• To assess sustained virologic response (SVR12) rates in participants receiving abbreviated DAA therapy.
• To determine the impact of treatment failure on subsequent retreatment outcomes.

Main Methods:

• A single-arm, multicenter trial (PURGE-C, NCT04042740) enrolled 45 participants with early HCV.
• Participants received 4 weeks of G/P treatment.
• The primary endpoint was SVR12, with re-treatment outcomes also collected.

Main Results:

• 84% of participants (38/45) achieved SVR12, with a 90% CI of 74%-91%.
• The study population was predominantly male (98%), White (51%), Hispanic (31%), with a median age of 36.
• Half of the participants were co-infected with HIV (51%), and 27% reported injecting drug use.

Conclusions:

• A 4-week G/P regimen achieved an 84% cure rate in individuals with early HCV infection.
• Treatment failure with this short course did not negatively affect retreatment outcomes.
• Abbreviated direct-acting antiviral (DAA) courses offer a promising strategy for HCV elimination, particularly in hard-to-reach populations.