Previous studies have found that sofosbuvir plus daclatasvir is a potent, pan-genotypic regimen that could be used for mass-scale hepatitis C virus treatment. While, this regimen has been widely tested on genotype 4, testing on other genotypes has been more limited. The authors recruited 1361 patients and treated them with a fixed combination of sofosbuvir 400 mg and daclatasvir 60 mg for 12 or 24 weeks with or without ribavirin. Primary endpoint was a sustained virologic response 12 weeks following the end of treatment (SVR12). The patients were 21% female, with a mean age of 50 years, 39% had cirrhosis, 22% were treatment-experienced, 47% had genotype 1, 41% genotype 3 and 2% had other genotypes. The genotype was unknown in 10%. The intention-to-treat and per-protocol SVR12 rates were 94.7% and 98.8%, respectively, and the treatment was well-tolerated. Therefore the use of combination sofosbuvir and daclatasvir leads to high SVR12 rates, equivalent to those seen in Phase III trials of other pan-genotypic options, but at a real-world cost of <$100 per patient.
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