AASLD 2018: AASLD Presidential Poster of Distinction
Abstract: #583 Retreatment with SOF/VEL/VOX in Treatment-Experienced Patients with and without HIV: The Resolve Study – Emily Covert, et. al. By Alan Franciscus
Retreatment of people who have not achieved a cure with a direct-acting antiviral (DAA) therapy is uncommon but an important unmet need. Retreatment is even more important in people coinfected with HIV or hepatitis B (HBV) or in people who had prior poor medication adherence. Additionally, some providers may not want to re-treat these ‘difficult-to-treat’ patients. In the current study (RESOLVE), the authors’ re-treated patients with a combination of sofosbuvir/velpatasvir/voxilaprevir (Vosevi) for 12 weeks.
There were 77 people enrolled—most were male, black and genotype 1a, 17 patients were coinfected with HIV, and two patients were co-infected with HBV. The majority of the patients in the trial (89%) had failed prior treatment with ledipasvir/sofosbuvir (Harvoni), but all DAA therapies were represented in the study.
The cure rate was 91% (70 of 77 patients). Two patients had not reached their cure determination results by the study completion date; five people discontinued treatment.
The most common side effects were fatigue, headache, diarrhea, abdominal pain, and constipation.
Conclusion: In this ‘difficult’ treatment population, a cure rate of 91% was achieved.
Editorial Comments: In my opinion, this is one of the most important studies on HCV treatment to come out of The Liver Meeting. Retreatment of the people who did not achieve a cure with DAA therapy will continue to be a problem even if it is a minority of people. I would like to understand what can be done to help the people who discontinued treatment early. Perhaps we could have reached 100% if there were other adherence strategies put in place.
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