Lee – Consulting: Bristol Myers Squibb, Gilead, Roche, Janssen, Vertex, Genentech, Merck, Abbvie; Grant/Research Support:
BMS, Gilead, Roche, Janssen, Merck, Vertex, Abbvie; Speaking and Teaching: BMS, Gilead, Roche, Merck, Vertex Sandra S. Lovell – Employment: AbbVie Guy Neff – Employment: AbbVie Paul Y. Kwo – Advisory Committees or Review Panels: Abbott, Novartis, Merck, Gilead, BMS, Janssen; Consulting: Vertex; Grant/Research Support: Roche, Vertex, GlaxoSmithKline, Merck, BMS, Abbott, Idenix, Vital Therapeutics, Gilead, Vertex, Merck, Idenix; Speaking and Teaching: Merck, Merck The following people have nothing to disclose: David J. Mutimer, Leticia Canizaro, Roger Trinh Background & Aim The availability of interferon-free regimens has ushered in a new era in find more the treatment of chronic hepatitis C. However, real-life data in cirrhotic patients, especially in patients with clinically significant portal hypertension (CSPH), are limited. We aimed to investigate the impact of MK-8669 in vivo portal pressure measured by hepatic venous pressure gradient (HVPG) on early viral kinetics
and on-treatment virologic response in patients treated with interferon-free regimens outside of clini cal trials. Patients & Methods Eighteen patients with chronic hepatitis C, cirrhosis and available information on HVPG treated with either sofosbuvir/daclatasvir (hepatitis C virus (HCV)-genotype (GT)1), simeprevir/daclatasvir (HCV-GT1 or 4), or sofosbuvir/ribavirin (HCV-GT3) were included in this retrospective study. HCV-RNA was assessed at baseline (BL), treatment day 2 (D2), week 1 (W1), week 2 (W2), week 3 (W3) and week 4 (W4) using the Abbott RealTime HCV quantitative assay. Rapid virologic response (RVR) was defined as target not detectable HCV-RNA at W4. HVPG >10mmHg selleck kinase inhibitor was considered as CSPH. Results Nine patients (50%) were infected with HCV-GT1 (subtype 1a:4[22%], 1a:5[28%]), 8 patients (44%) with HCV-GT3 and one patient (6%) with HCV-GT4. The majority of patients were Child-Pugh stage A (11/18[61%]), while stage B was observed in
7 patients (39%). No patients had stage C cirrhosis. Fourteen patients (78%) had CSPH, with a median HVPG of 12.5mmHg. HCV-RNA log-drop was not statistically significantly correlated with HVPG at any time point: D2:r=−0.099,P=0.715; W1:r=−0.297,P=0.247; W2:r = −0.042,P = 0.8 83; W3:r = −0.019,P = 0.95; W4:r=0.014,P=0.959. Moreover, the proportion of patients with HCV-RNA below the lower limit of quantification was comparable between patients with (high) and without (low) a HVPG above the median: W1: low:0/8(0%), high:1/9(11%); W2: low:2/8(25%), high:1/7 (14%); W3: low:1/7(14%), high:1/6(17%); W4: low:5/9 (56%), high:4/6(67%). RVR was observed in 2 out of 15 patients (13%), who both had a HVPG below the median.