Efficacy of precision therapy with direct-acting antiviral drugs for patients with chronic HCV genotype 1b infection

Objective To evaluate the efficacy of precision therapy with direct-acting antiviral drugs (DAAs) for patients with chronic HCV gene type 1b infection. Methods One hundred and thirteen patients with chronic HCV genotype 1b infection admitted in the Department of Infectious Diseases of First Hospital of Shanxi Medical University from January 2018 to July 2019 were enrolled, including 89 patients with chronic hepatitis and 24 patients with cirrhosis. Different DAAs therapeutic schedule were taken based on liver function, kidney function, complication and treatment costs. Seventy-two patients were treated with pan-genotype drugs, including 43 patients treated with Sofosbuvir and Velpatasvir (SOF+ VEL), 13 treated with Sofosbuvir and Ribavirin (SOF+ RBV), and 16 treated with Sofosbuvir and Daclatasvir (SOF+ DCV). Forty one patients were treated with specific genotype DAAs, including 15 treated with Ombitasvir and Dasabuvir (OBV+ DSV), and 26 treated with Elbasvir and Grazoprevir tablets (EBR+ GZR). Pair t test and Chi-square test were used to compare virological response rate, the liver function and the adverse reactions were observed. Results The super-rapid virological response (SRVR) rate with DAAs treatment at 1 week was 88.5% (100/113), and the rapid virological response (RVR) at 4 weeks of treatment was 98.2%(111/113). There was no significant differences in SRVR and RVR among the patients treated with five treatment regimens (χ2=5.95 and 1.04, P>0.05), all the patients obtained complete early virological response (CEVR) at 12 weeks and sustained virological response (SVR12) at 12 weeks after treatment. Besides, there were no significant differences in SRVR and RVR between pan-genotype and gene-specific drugs (χ2=0.03 and 0.17, P>0.05), both CEVR and SVR12 reached 100% in all patients. The liver transaminase levels were improved in patients undergoing pan-genotype or gene-specific drugs treatment. Mild adverse reactions were observed in 5 cases, hemolysis occurred in 1 patient and it was cured after replacement of drugs. Conclusion Both pan-genotype and specific genotypes of DAAs can achieve high virological response rates. Genotypic testing should be performed before antiviral therapy, in order to accurately select treatment options and to save costs. Key words: Hepatitis C, chronic; Genotype 1b; Direct-acting antiviral drugs; Clinical features; Efficacy; Safety