Real-world comparison of ledipasvir/sofosbuvir and elbasvir/grazoprevir in Veterans with genotype 1 chronic hepatitis C Trang Conn, Vian Nguyen, Emily Cartwright Atlanta Veterans Affairs Medical Center - Atlanta, GA
Background/Purpose: Hepatitis C virus (HCV) infection is the most common blood-borne pathogen estimated to affect about 2.7 million people in the United States. Over 170,000 veterans have chronic HCV infection. In FY17, the Atlanta VA Medical Center (AVAMC) treated the second highest number of veterans in the entire VHA network. Among the oral, single tablet, once daily regimens for HCV genotype 1, there is currently no direct comparison studies for ledipasvir/sofosbuvir and elbasvir/grazoprevir in achieving sustained virologic response at 12 weeks (SVR12) for genotype 1.
Methodology: We conducted a retrospective chart review of patients on either elbasvir/grazoprevir or ledipasvir/sofosbuvir with a planned 12 weeks duration between January 1, 2016 and April 30, 2017 at the Atlanta VA Medical Center. The VA Clinical Case Registry and Corporate Data Warehouse will be used to identify patients. Additional information will be obtained by performing a medical chat review using the computerized patient record system. Data collected include age, sex, race, serum creatinine, estimated glomerular filtration rate, albumin, alanine aminotransferase, aspartate aminotransferase, bilirubin, HCV treatment history, baseline nonstructural protein SA (NS5A), resistance associated variants (RAVs) test, baseline Fibrosis-4 score, Human Immunodeficiency Virus coinfection, medication adherence, proton pump inhibitor use, and presence of chronic kidney disease. Patients must be > 18 years of age, have genotype 1a or genotype 1b, and a negative baseline NS5A RAVs. Patients will be excluded if they have genotype 4, received a treatment duration >12 weeks, have decompensated cirrhosis (including the presence of hepatocellular carcinoma), or require the addition of ribavirin.
Presentation Objective: To determine if elbasvir/grazoprevir and ledipasvir/sofosbuvir will provide similar SVR12 rates in patients with genotype 1 HCV infections.
Self-Assessment: True or False: Ledipasvir/sofosbuvir and elbasvir/grazoprevir have been shown to achieve high SVR12 rates.
