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San Francisco—Hepatitis C patients who fail treatment with direct-acting antivirals (DAA) have no clear next steps. For those who have resistance-associated variants in NS5A, the path is further obscured by their documented persistence for up to 96 weeks post-treatment.

Researchers presented a promising way forward at AASLD that used a multi-targeted regimen to achieve sustained virologic response in 100% of retreated patients, F Poordad and team told attendees of the 2015 annual meeting of the AASLD, held here recently. Dr. Poordad presented Late Breaking abstract 20 (LB-20). You can find the entire abstract here.

Of the 22 patients enrolled in the study, 20 had a genotype 1a infection and 6 had compensated cirrhosis. All had experienced treatment failure on a variety of DAAs; 6 had previously been treated with ombitasvir/paritaprevir/ritonavir and dasabuvir initially.

Patients with genotype 1 infections without cirrhosis received ombitasvir/paritaprevir/ritonavir and dasabuvir plus sofosbuvir for 12 weeks. Those who had genotype 1a infections without cirrhosis also received ribavirin and those with both genotype 1a infections and cirrhosis received the combination with ribavirin for 24 weeks.

All patients treated for 12 weeks achieved sustained virologic response at 4 weeks post treatment, although one patient with a genotype 1a infection without cirrhosis who was initially assigned to 12 weeks of therapy had treatment extended to 24 weeks as a result of not achieving HCV RNA of less than 25 IU/mL at week 4 of treatment. All patients who received 24 weeks of therapy had an undetectable viral load at the time of the abstract submission.  One patient who developed pneumonia, unrelated to the study drugs, and withdrew at week 10 continues to have undetectable viral loads.