{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T12:42:40Z","timestamp":1766580160478,"version":"3.37.3"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite the current highly effective therapies with direct-acting antiviral agents (DAAs), some patients with chronic hepatitis C virus (HCV) infection still do not achieve sustained virological response (SVR) and require retreatment. Sofosbuvir\/velpatasvir\/voxilaprevir (SVV) is recommended as the first-line retreatment option for most patients. The aim of this study was to evaluate the efficacy of SVV as salvage therapy after at least one course of DAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected on all HCV-infected patients who failed DAAs and were prescribed SVV from a prospective Canadian registry (CANUHC) including 17 sites across Canada. Factors associated with failure to achieve SVR with SVV therapy and the utility of RAS testing and ribavirin use were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 128 patients received SVV after non-SVR with DAA treatment: 80% male, median age 57.5 (31\u201386), 44% cirrhotic, and 17 patients post liver transplant. First line regimens included: sofosbuvir\/velpatasvir (27.3%), sofosbuvir\/ledipasvir (26.5%), grazoprevir\/elbasvir (12.5%), other (33.5%). Ribavirin was added to SVV in 26 patients due to past sofosbuvir\/velpatasvir use (n\u2005=\u20058), complex resistance associated substitution profiles (n\u2005=\u200516) and\/or cirrhosis (n\u2005=\u20059). Overall SVR rate was 96% (123\/128). Of 35 patients who previously failed sofosbuvir\/velpatasvir, 31 (88.5%) achieved SVR compared to 92 of 93 (99%) among those receiving any other regimen (P\u2005=\u2005.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Similar to reports from phase 3 clinical trials, SVV proved highly effective as salvage therapy for patients who failed a previous DAA therapy. Those who failed SVV had at least 2 of the following factors: genotype 3, presence of cirrhosis, past liver transplantation, past exposure to sofosbuvir\/velpatasvir and\/or complex resistance profiles.<\/jats:p><\/jats:sec>","DOI":"10.1093\/cid\/ciaa1510","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T20:14:54Z","timestamp":1614629694000},"page":"e799-e805","source":"Crossref","is-referenced-by-count":18,"title":["Salvage Therapy with Sofosbuvir\/Velpatasvir\/Voxilaprevir in DAA-experienced Patients: Results from a Prospective Canadian Registry"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-7543","authenticated-orcid":false,"given":"Fernanda Q","family":"Onofrio","sequence":"first","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis","family":"Cooper","sequence":"additional","affiliation":[{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio M","family":"Borgia","sequence":"additional","affiliation":[{"name":"William Osler Health System, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Louise","family":"Vachon","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Universitaire de Qu\u00e9bec-Universit\u00e9 Laval, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alnoor","family":"Ramji","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie B","family":"Lilly","sequence":"additional","affiliation":[{"name":"Multiorgan Transplant Program, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Saskatchewan, Saskatchewan, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Booth","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izza","family":"Sattar","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidy","family":"Morales","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Conway","sequence":"additional","affiliation":[{"name":"Vancouver Infectious Diseases Centre, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan J","family":"Feld","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"2021060106123726300_CIT0001","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1021\/acs.biochem.7b01157","article-title":"Biochemical basis of vosevi, a new treatment for hepatitis C. 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