The Context:
Approximately five percent of people treated for hepatitis C fail initial treatment. And, there is a growing group of people worldwide that need second-line therapy. Untreated hepatitis can lead to cirrhosis, liver cancer, and premature death.
The World Health Organization (WHO) recommends a specific drug—sofosbuvir/velpatasvir/voxilaprevir—for retreatment in these individuals. However, this drug is not affordable to many low- and middle-income countries. In addition, procurement volumes are not high enough for the costs to reduce substantially. As a result, many of these countries do not have access to the drug. Retrospective data suggest that retreating with SOF/VEL+RBV may be effective. Until this study, there was no prospective evidence of how this drug would be tolerated for retreatment in real-world settings.
The Study:
This study describes results from a national SOF/VEL+RBV retreatment program in Rwanda from November 2021-October 2022. About 231 individuals participated in the study, which assessed the feasibility of administering the drug over a six month period. It also evaluated the side effects and outcomes reported by the study participants.
The Findings:
This study found that SOF/VEL+RBV was safe and cured 75 percent of those who enrolled in the treatment program. Clinicians now have this treatment option as an important alternative in countries that cannot afford the WHO-recommended regimen. If it is scaled up, it has the potential to cure people who failed initial treatment, ultimately preventing cancer and saving lives.
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