STUDY Abstract: THU-365 Salvage treatment of HCV patients by Sofosbuvir, Daclatasvir, Simeprevir and Ribavirin after repeated treatment failures is associated with SVR and reduced risk of hepatocellular carcinoma – A. Hanafy, et al.
Study Aims and Results: To evaluate sofosbuvir, daclatasvir, simeprevir plus ribavirin treatment for 12 weeks for people who had previously failed a course of direct-acting antiviral therapy compared to a similar group who received a placebo (sugar pill). The goal was to compare the reduced risk of hepatocellular carcinoma (liver cancer) between the treated and untreated group. The two groups (50 people treated; 50 people untreated) were evenly matched by age and gender. The two groups were followed for two years. The cure rate was 100% and the treatment was safe and well tolerated.
One case (2%) in the treated group and 3 cases (6%) in the placebo group developed liver cancer. The treated group had a significantly longer mean time to develop liver cancer than the placebo group. In a detailed analysis of the effects of the drugs showed that people who did not have treatment were 9 times more likely to develop liver cancer.
Conclusion: The combination of sofosbuvir, daclatasvir, simeprevir, plus ribavirin (salvage therapy) produced 100% cure rates and a lower risk of liver cancer in people who had failed previous DAA therapy(s).
Editorial Comments: Not only did this salvage therapy produce 100% cure rate, it also reduced the rate of liver cancer. This study demonstrates that we can cure everyone with hepatitis C if we can just put our minds, money, and drugs to the task.
In this metropolitan sample of an HCV population, young adults were more likely to be tested, HCV antibody positive, accept HCV viral load testing and HCV treatment, but less likely to engage in care.
Four percent started treatment while in jail. Within 25 days of release, 26 (30%) of the participants were linked to HCV care, and 16 (18%) stared HCV treatment, but 35 (38%) were lost to follow-up.
Not only did this salvage therapy produce 100% cure rate, it also reduced the rate of liver cancer. This study demonstrates that we can cure everyone with hepatitis C if we can just put our minds, money, and drugs to the task.
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