PE-074 : Efficacy and Safety of Sofosbuvir and Ribavirin in Treatment of HCV Genotype 2

Aims: Treatment of Hepatitis C virus (HCV) infections with genotype 2 entered new era by introduction of direct antiviral-agents (DAA). The current standard therapy is 12 weeks of sofosbuvir plus ribavirin and has been used in South Korea since 2016. Several reports showed substantially varied sustained virological response (SVR) in distinct groups. Therefore, assessing the efficacy and safety of DAA therapy is warranted. Methods: From May of 2016 to March of 2017, 159 patients were treated with sofosbuvir and ribavirin for HCV genotype 2 at Chonnam national university hospital and Hwasun chonnam national university hospital. Among these patients, 8 patients started treatment after March of 2017, and other 8 patients were lost during follow-up. Finally, 143 patients were retrospectively analyzed. Results: Among 159 patients, there were 17 patients (10.7%) who developed anemia (which was defined as hemoglobin less than 10mg/dL) during DAA treatment and at there were statistic significant relationship between anemia development and ribavirin dosage (p=0.013). 16 patients reduced ribavirin dosage during DAA treatment and among these patients, 11 patients reduced ribavirin due to anemia. 94 patients started their first DAA medication before October of 2016 and they were analyzed for their presence of SVR. All of 94 patients were treated with sofosbuvir plus ribavirin and average dose of ribavirin was 969.9mg and 16.1mg/kg. SVR rate of 99 patients appeared to be 100%. There were 17 patients (18.1%) who were treated with ribavirin dosage less than 1000mg and all of them reached SVR. Although all of the patients had SVR eventually, there were 3 patients who had detectable HCV RNA counts at 4 week follow-up exam. Also there weren’t any relationships between ribavirin dosage and HCV RNA count decrement at 4th week of treatment. 7 patients were treated for HCC before DAA treatment and no recurrence was found during and after the DAA treatment. 1 patient developed HCC 1 month after confirmation of SVR and after tumor resection operation, patient had no recurrence so far. Conclusions: Successful outcomes of HCV genotype 2 can be expected from sofosbuvir plus ribavirin. Anemia seems to occur at higher ribavirin dose. Although current guidelines recommend ribavirin dosage at least more than 1000mg, our data shows that SVR can be achieved with ribavirin dosage less than 1000mg.