Genotype-specific versus pangenotypic regimens in patients infected with HCV genotype 1b in real-world settings.

INTRODUCTION The introduction of direct-acting antivirals (DAA) has provided us with hope to eliminate hepatitis C virus (HCV) infection as a significant public health problem in the coming years. OBJECTIVE Our study aimed to compare the effectiveness and safety between genotype-specific and pangenotypic regimens in GT1b infected patients treated in real-world experience settings. PATIENTS AND METHODS The patients were selected from 990 HCV infected patients treated with DAA in the Department of Infectious Diseases in Kielce, who initiated the therapy between July, 1 2015 and December, 31 2020. RESULTS A total of 795 GT1b infected patients with a median age of 51 years, female predominance (55%), and a 21.1% rate of cirrhosis were included in the analysis. 69.9% of patients were treated with genotype-specific regimens. Those patients were significantly older, with a higher proportion of treatment-experienced individuals and those with advanced liver fibrosis and cirrhosis than patients assigned to pangenotypic regimens. An overall sustained virologic response (SVR) rate of 97.9% in the intention-to-treat analysis and 99% after excluding non-virologic nonresponders was achieved, with no significant difference between patients in the two treatment arms. Significantly higher proportions of males (P = 0.001) and DAA-experienced patients (P = 0.049) were documented among virologic nonresponders. CONCLUSIONS We confirmed very high effectiveness and a good safety profile of both genotype-specific and pangenotypic regimens used in patients with GT1b HCV infection, and we found no significant differences between these two generations of medications. Male sex and previous treatment with DAA were identified as negative predictors for therapy effectiveness.