Clin Mol Hepatol.  2021 Jan;27(1):125-135. 10.3350/cmh.2020.0023.

Efficacy and safety of ledipasvir/sofosbuvir in 5,028 Mongolian patients infected with genotype 1 hepatitis C virus: A multicenter study

Affiliations
  • 1Department of Infectious Diseases, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  • 2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 3Mongolian Academy of Medical Sciences, Ulaanbaatar, Mongolia
  • 4Mongolian Association for the Study of Liver Diseases, Ulaanbaatar, Mongolia
  • 5Department of Hepatology, Happy Veritas Liver Diagnostics Center, Ulaanbaatar, Mongolia
  • 6Department of Internal Medicine, University General Hospital, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
  • 7Department of Hepatology, National Center for Communicable Diseases, Ulaanbaatar, Mongolia
  • 8Department of Gastroenterology, Second State Central Hospital, Ulaanbaatar, Mongolia
  • 9Department of Gastroenterology, Third State Central Hospital, Ulaanbaatar, Mongolia
  • 10School of Dentistry, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia

Abstract

Background/Aims
Ledipasvir/sofosbuvir (LDV/SOF) shows high efficacy and safety in patients with genotype 1-hepatitis C virus (HCV). We aimed to investigate the efficacy and safety of LDV/SOF in real-world Mongolian patients.
Methods
Between 2015 to 2019, 23 (0.5%) and 5,005 patients (99.5%) with genotype 1a and 1b HCV, respectively, were treated with a fixed-dose tablet containing 90 mg ledipasvir and 400 mg sofosbuvir for 12 weeks, and 81 patients (1.6%) with previous experience of interferon (IFN)-based treatment received additional 1,000 mg ribavirin. HCV RNA was measured at 4, 12, and 24 weeks after the first dose to determine rapid virologic response, end of treatment response (ETR), and sustained virologic response at 12 weeks after end of treatment (SVR12).
Results
Most patients (n=5,008; 99.6%) achieved ETR and SVR12 without virologic relapse. Patients with genotype 1a showed low rates of ETR and SVR12 in only 16 patients (69.6%). There was no significant difference in SVR12 rate between patients regardless of IFN experience (n=81; 1.6%), cirrhosis (n=1,151; 22.9%), HCV RNA >6×106 IU/mL (n=866; 17.2%), or liver stiffness >9.6 kPa (n=1,721; 34.2%) (100.0%, 99.3%, 99.4%, and 99.4%, respectively). No severe adverse events (AEs) were reported, and there was no dose reduction or interruption due to AE. The most common AEs were headache (n=472; 9.4%), fatigue (n=306; 6.2%), abdominal discomfort (n=295; 5.9%), and skin rash (n=141; 2.8%).
Conclusions
LDV/SOF showed high efficacy and safety for patients with genotype 1, especially 1b HCV, in Mongolia. The real-world data might be applicable to patients in other Asian-Pacific countries.

Keyword

Hepatitis C, Chronic; Ledipasvir; Sofosbuvir; Mongolia; Real-world
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