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San Francisco—Patients who have failed therapy for HCV with elbasvir/grazoprevir (EBR/GZR) and sofosbuvir may need a boost from ribavirin.

A study of 25 patients with HCV genotype 1 who had relapsed following treatment with combination of EBR/GZR and sofosbuvir for 4 (17), 6 (7) or 8 (1) weeks showed that the addition of ribavirin to the combination produced sustained virologic response at 4 weeks after treatment in 100% of patients who completed treatment. Participants took the 3-drug combination for 12 weeks.

Notably, of the 22 genotype 1a participants, 45% had resistance-associated variants in NS5A and 59% in NS3, based on population sequencing at the start of the study. The 3 patients with genotype 1b infections had no resistance-associated variants, according to Late Breaking abstract 12 (LB-12) by E Lawitz and colleagues at the 2015 annual meeting of the AASLD. You can find the entire abstract here.

Two patients did not complete the study. One was lost to follow up after treatment day 3, at which time viral load was 363 IU/mL, and the other had an undetectable viral load when lost to follow up following 4 weeks of treatment. No patients experienced adverse events that caused them to discontinue the study and fatigue was the only notable adverse event experienced by more 10% of the participants.