Abstract
This study retrospectively analyzed the risk factors associated with liver cancer and cirrhosis in 358 HCV infected chinese patients with positive viral load. Among them, 80 patients treated with sofosbuvir-velpatavir (SOF-VEL) were further investigated for the efficacy and safety. An unusual SOF-VEL resistance case was investigated for the resistance-associated substitutions (RAS) using next-generation sequencing. HCV genotype 1 infection (45.5%) was most prevalent in this Chinese cohort. By single and multivariate factor analyses it was found that genotype 3 infection had a poorer prognosis. Age ≥50 years, male gender, Child-Pugh Grade B and C, and FIB-4 ≥3.25 were risk factors for liver cancer, while age ≥50 years, with diabetes, and ANA positive were risk factors for cirrhosis. Treating CHC patients with SOF-VEL revealed a sustained virologic response (SVR12) rate reaching 95%. The patient who experienced response-relapses once SOF-VEL was withdrawn had a HCV genotype 2a strain infection which harbored F28S mutation in NS5A, and T273A, M289L, A421V mutations in NS5B as RAS sites. We concluded thatSOF-VEL-basedpan-genotypic direct-acting antiviral treatment for CHC patients resulted in a high rate of achieving primary endpoint. However, the patients should be carefully monitored for SVR12 after the end of treatment.