While direct-acting antivirals have been successful in treating chronic hepatitis C virus (HCV) infection, not much is known about their safety and efficacy for American Indians or Alaska Natives.
Lisa Townshend-Bulson, a nurse practitioner with the Alaska Native Tribal Health Consortium in Anchorage, and colleagues sought to determine the outcomes of treatment with sofosbuvir-based direct-acting antiviral therapy in these populations. Three different antiviral regimens were used: Sovaldi (sofosbuvir) plus weight-based ribavarin, Harvoni (sofosbuvir/ledipasvir) and Epclusa (sofosbuvir/velpatasvir).
Participants in the study were selected from across the Alaska Tribal Health System: Alaska Native or American Indian people at least 18 years old who tested positive for HCV antibodies and HCV RNA. A total of 501 people with an average age of 54 were included. The researchers looked at baseline factors prior to treatment, whether participants achieved sustained virological response (SVR) and any side effects that occurred. SVR, which is considered a cure, means individual have an undetectable HCV viral load 12 weeks after completing treatment.
The researchers found that 95% of participants who received one of the three treatment regimens attained SVR. The SVR rate was 93% for people with liver cirrhosis and 91% for those with HCV genotype 3, two groups that typically do not respond as well to treatment.
“In the real-world setting, sofosbuvir-based treatment is safe, effective and well tolerated in Alaska Native/American Indian patients,” wrote the researchers. “Sustained virologic response was high regardless of HCV genotype or cirrhosis status.”
Click here to read the study in PLOS ONE.