Vol.:(0123456789) 1 3
Digestive Diseases and Sciences
https://doi.org/10.1007/s10620-020-06234-1
ORIGINAL ARTICLE
Evolution of Hepatitis C Virus Treatment During the Era
of Sofosbuvir‑Based Therapies: A Real‑World Experience in France
Denis Ouzan
1
· Dominique Larrey
2
· Dominique Guyader
3
· André‑Jean Remy
4
· Ghassan Riachi
5
·
Fréderic Heluwaert
6
· Régine Truchi
7
· Jean‑Marc Combis
8
· François Bailly
9
· Isabelle Rosa
10
· Christophe Hézode
11
·
Denise Glorian‑Petraud
11
· Olivier Libert
11
· Heribert Ramroth
12
· Tarik Asselah
13,21
· Gérard Thiefn
14
·
Dominique Roulot
15
· Bruno Roche
16
· Vincent Leroy
17
· Jérôme Dumortier
18
· Dominique Thabut
19
·
Stanislas Pol
20
on behalf of the HELIOS study group
Received: 24 September 2018 / Accepted: 24 March 2020
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
Background Treatment of hepatitis C virus (HCV) has been dramatically improved with the introduction of direct-acting
antiviral agents (DAAs). Universal access to pangenotypic DAAs was provided in France from 2017, expanding the type
of patients treated. Real-world studies are important to confrm efectiveness and safety in clinical practice, particularly in
vulnerable populations.
Aims To assess real-world efectiveness and safety of sofosbuvir-based therapy in adults with chronic HCV infection before
and after universal access to DAAs in France.
Methods This multicenter, non-interventional, prospective study assessed the efectiveness, safety, patient-reported outcomes
and adherence with sofosbuvir-based regimens from October 2015 to July 2016 (Period 1: sofosbuvir-based therapy excluding
sofosbuvir/velpatasvir) and from October 2017 to July 2018 (Period 2: pangenotypic sofosbuvir/velpatasvir-based therapy).
Results Baseline data were documented for 1029 patients. Overall, 797 (77%) had sustained virologic response data avail-
able ≥ 9 weeks after treatment completion. Per protocol response was high (97%) irrespective of age, alcohol consumption,
recreational drug use, or HIV/HCV coinfection. Adverse events occurred in approximately 25% of patients with the majority
experiencing Grade 1 or 2 events. Sofosbuvir-based regimens improved health-related quality of life from baseline to end of
treatment in patients with data at all timepoints. Overall, 99% of patients reported total or almost total adherence to therapy.
Conclusions Sofosbuvir-based therapy, including pangenotypic sofosbuvir/velpatasvir, is efective for the treatment of HCV
in real-world clinical practice. This is an important step towards HCV elimination.
Keywords Hepatitis C · Sofosbuvir · Treatment outcome · Practice guidelines as topic · France
Abbreviations
ALT Alanine aminotransferase
AP-HP Assistance Publique-Hôpitaux de Paris
BMI Body mass index
CCTIRS Comité consultatif sur le traitement de
l’information en matière de recherche
CI Confdence interval
CNIL Commission nationale de l’informatique et des
libertés
DAA Direct-acting antiviral agent
DCV Daclatasvir
EOT End of treatment
EQ-5D EuroQOL fve dimensions
F Fibrosis stage
GT Genotype
HBV Hepatitis B virus
HCC Hepatocellular carcinoma
HCV Hepatitis C virus
HRQoL Health-related quality of life
HELIOS HEpatitis C real-LIfe study for patients On
Sofosbuvir
HIV Human immunodefciency virus
Electronic supplementary material The online version of this
article (https://doi.org/10.1007/s10620-020-06234-1) contains
supplementary material, which is available to authorized users.
* Stanislas Pol
stanislas.pol@aphp.fr
Extended author information available on the last page of the article