Highlights from easl 2014.

Twelve-week sustained viral response (SVR) rates ranging from 94% to 99% have been reported in treatmentexperienced patients infected with genotype 1 hepatitis C virus (HCV) infection following 12 to 24 weeks of therapy with sofosbuvir (Sovaldi, Gilead) and ledipasvir (fixed-dose combination) with or without ribavirin. The study population included patients with cirrhosis and those who failed previous therapy or relapsed. No significant differences were seen between study arms. The findings of this phase 3 study, termed ION-2, were reported by Nezam H. Afdhal, MD, chief of hepatology and director of the Liver Center at Beth Israel Deaconess Medical Center in Boston, Massachusetts, at the 49th annual meeting of the European Association for the Study of the Liver (EASL 2014), which took place April 9-13, 2014 in London, England (Abstract O109). A total of 440 adult patients (mean age, 56 years) infected with genotype 1 HCV, including patients who had failed previous interferon-based therapy and patients with cirrhosis, were included in the study. Patients were divided into 2 groups that received 12 or 24 weeks of therapy, and these groups were, in turn, divided into groups of patients who received sofosbuvir plus ledipasvir or sofosbuvir plus ledipasvir plus ribavirin. Each group included a relatively equal proportion of patients who were cirrhotic, previous nonresponders to therapy, or had the IL28B CC genotype (Table 1). The SVR12 was the least robust—but still strong— among those patients with cirrhosis who received 12 weeks of therapy (86% in patients receiving sofosbuvir plus ledipasvir and 82% in patients receiving triple therapy), although the SVR12 reached 100% in cirrhotic patients receiving 24 weeks of therapy regardless of whether the treatment regimen included ribavirin. Otherwise, SVR12 rates exceeding 90% were achieved regardless of type of previous treatment failure, sex, race, baseline body mass index, HCV genotype, IL28B genotype, baseline HCV RNA, cirrhosis status, or type of previous HCV therapy received.