interferon free therapy with and without ribavirin for genotype 1 hcv cirrhotic patients in the real world experience

Background: in the interferon era, patients with hcv-related cirrhosis were considered hard to treat due to contraindications to therapy, safety issues, and poor response. objectives: we investigated interferon-free regimens in cirrhotic patients in real-world practice. methods: we analyzed data of hcv infected patients with liver cirrhosis conducted in 22 polish hepatology centers. they were assigned to a treatment schedule based on physician decision. data were collected retrospectively by an online questionnaire. results: in total, 1113 patients infected with genotype 1 hcv were enrolled to the analysis, 96.6% presented gt1b infection. a total of 56% were treatment-experienced, mostly with pegifn + rbv, 77.2% of group presented comorbidities with the most frequent hypertension and diabetes,73.2% patients were treated with concomitant medications, and 31% of cohort was assigned to rbv-free regimen, majority of them to obv/ptv/r + dsv. overall, 94.7% patients achieved the sustained virological response in intent-to-treat analysis, with comparable rate for rbv-free and rbv-containing options (94.2% vs. 94.9%). treatment course was more often modified in rbv-containing group, whereas rate of discontinuation was the same for both cohorts. adverse events were observed in 41% with the most common weakness/fatigue; more frequently in rbv-containing regimens (43% vs. 36.6%). serious adverse events were reported in 4.1% patients. a total of 16 deaths not related to study drugs were documented, mostly in rbv-containing group. conclusions: we confirmed effectiveness of the interferon-free regimens without ribavirin in real-world cohort of cirrhotic patients with chronic hcv infection genotype 1. therapy was well tolerated with infrequent adverse events.