Sofosbuvir/velpatasvir/voxilaprevir for patients with chronic hepatitis C virus infection previously treated with NS5A direct-acting antivirals: a real-world multicenter cohort in Taiwan

Chen Hua Liu, Cheng Yuan Peng, Chun Jen Liu, Chi Yi Chen, Ching Chu Lo, Kuo Chih Tseng, Pei Yuan Su, Wei Yu Kao, Ming Chang Tsai, Hung Da Tung, Hao Tsai Cheng, Fu Jen Lee, Chia Sheng Huang, Ke Jhang Huang, Yu Lueng Shih, Sheng Shun Yang, Jo Hsuan Wu, Hsueh Chou Lai, Yu Jen Fang, Po Yueh ChenJow Jyh Hwang, Chi Wei Tseng, Wei Wen Su, Chun Chao Chang, Pei Lun Lee, Jyh Jou Chen, Chi Yang Chang, Tsai Yuan Hsieh, Chung Hsin Chang, Yi Jie Huang, Jia Horng Kao

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Real-world data are scarce about the effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) for retreating East Asian patients with hepatitis C virus (HCV) infection who previously received NS5A direct-acting antivirals (DAAs). We conducted a multicenter study to assess the performance of SOF/VEL/VOX in patients who were not responsive to prior NS5A inhibitors in Taiwan. Methods: Between September 2021 and May 2022, 107 patients who failed NS5A inhibitor-containing DAAs with SOF/VEL/VOX salvage therapy for 12 weeks were included at 16 academic centers. The sustained virologic response at off-treatment week 12 (SVR12) was assessed in the evaluable (EP) and per-protocol (PP) populations. The safety profiles were also reported. Results: All patients completed 12 weeks of treatment and achieved an end-of-treatment virologic response. The SVR12 rates were 97.2% (95% confidence interval (CI) 92.1–99.0%) and 100% (95% CI 96.4–100%) in EP and PP populations. Three (2.8%) patients were lost to off-treatment follow-up and did not meet SVR12 in the EP population. No baseline factors predicted SVR12. Two (1.9%) not-fatal serious adverse events (AE) occurred but were unrelated to SOF/VEL/VOX. Sixteen (15.0%) had grade 2 total bilirubin elevation, and three (2.8%) had grade 2 alanine transaminase (ALT) elevation. Thirteen (81.3%) of the 16 patients with grade 2 total bilirubin elevation had unconjugated hyperbilirubinemia. The estimated glomerular filtration rates (eGFR) were comparable between baseline and SVR12, regardless of baseline renal reserve. Conclusions: SOF/VEL/VOX is highly efficacious and well-tolerated for East Asian HCV patients previously treated with NS5A inhibitor-containing DAAs. Clinical trials registration: The study was not a drug trial. There was no need for clinical trial registration.

Original languageEnglish
Pages (from-to)291-302
Number of pages12
JournalHepatology International
Issue number2
Publication statusAccepted/In press - 2023


  • Direct-acting antiviral
  • Effectiveness
  • Hepatitis C virus
  • Pangenotypic
  • Resistance-associated substitution
  • Safety
  • Sofosbuvir
  • Sustained virologic response
  • Velpatasvir
  • Voxilaprevir

ASJC Scopus subject areas

  • Hepatology


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