{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T05:42:04Z","timestamp":1775886124607,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,4]],"date-time":"2019-07-04T00:00:00Z","timestamp":1562198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The role of ribavirin (RBV) in the era of direct\u2010acting antivirals (DAA) is not clear, and DAA studies have been largely genotype\u2010 and regimen\u2010specific. Using data from the Chronic Hepatitis Cohort Study, we evaluated the role of RBV and increased DAA treatment duration among patients with chronic hepatitis C (HCV) in routine clinical care. We performed\u00a0multivariable analysis of data from 4133 patients receiving any of the following: sofosbuvir (SOF); daclatasvir\u00a0+\u00a0SOF; grazoprevir\u00a0+\u00a0elbasvir; paritaprevir\/ritonavir\u00a0+\u00a0ombitasvir; simeprevir\u00a0+\u00a0SOF; and SOF\u00a0+\u00a0ledipasvir; SOF\u00a0+\u00a0velpatasvir\u00a0\u00b1\u00a0voxilaprevir; and glecaprevir\u00a0+\u00a0pibrentasvir\u2014all with\/ without RBV. Inverse probability treatment weighting was used to adjust for treatment selection bias. Sustained virological response (SVR) was defined by undetectable HCV RNA 12\u00a0weeks after end of therapy. The overall SVR rate was 95%. Mean treatment duration was 12\u00a0\u00b1\u00a04.5\u00a0weeks. The final model included treatment duration and diabetes, as well as the interaction of RBV with previous treatment status (treatment na\u00efve, interferon treatment failure [TF] or previous DAA TF), cirrhosis status, and HCV genotype (GT). Each one\u2010month increment of treatment duration increased odds of SVR by 99% (aOR\u00a0=\u00a01.99). Diabetes, previous DAA TF, and decompensated cirrhosis significantly reduced odds of SVR. RBV significantly increased the likelihood of SVR among patients with decompensated cirrhosis (aOR\u00a0=\u00a05.05), previous DAA treatment failure (aOR\u00a0=\u00a05.43), and GT3 (aOR\u00a0=\u00a013.28). Among RBV\u2010free regimens, patients with GT3 were less likely to achieve SVR than those with GT1 or 2 (aOR 0.07). Diabetes, decompensated cirrhosis, and prior DAA TF independently reduced the likelihood of SVR. Longer treatment duration increased likelihood of SVR. Conclusion:\u00a0RBV increased likelihood of SVR among patients with GT3, previous DAA TF, or decompensated cirrhosis.<\/jats:p>","DOI":"10.1111\/jvh.13162","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T06:09:51Z","timestamp":1560492591000},"page":"1210-1217","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Adjuvant ribavirin and longer direct\u2010acting antiviral treatment duration improve sustained virological response among hepatitis C patients at risk of treatment failure"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3313-6428","authenticated-orcid":false,"given":"Mei","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health System Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan\u2010Han","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health System Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Henry Ford Health System Detroit Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne C.","family":"Moorman","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip R.","family":"Spradling","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyasu H.","family":"Teshale","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-6805","authenticated-orcid":false,"given":"Joseph A.","family":"Boscarino","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Services Research Geisinger Clinic Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yihe G.","family":"Daida","sequence":"additional","affiliation":[{"name":"Center for Health Research Kaiser Permanente\u2013Hawai\u2019i Waipahu Hawaii"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Center 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Hepatology Henry Ford Health System Detroit Michigan"},{"name":"Wayne State University School of Medicine Detroit 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