Consideration of ledipasvir/sofosbuvir as an alternative to glecaprevir/pibrentasvir based upon on-treatment FIB-4 changes and sustained virologic response at 12 weeks in hepatitis C genotype 1 and 2 infections: A propensity score-matched study

Limited data are available on the effectiveness of ledipasvir/sofosbuvir (LDV/SOF) compared with glecaprevir/pibrentasvir (GLE/PIB) for the treatment of hepatitis C virus genotype 2 infection. The sustained virologic response at 12 weeks (SVR 12) rate and on-treatment fibrosis index-4 (FIB-4) change in HCV GT-1 and GT-2 patients receiving LDV/SOF and GLE/PIB treatments were compared using propensity score matching (PSM). The proportion of treatment-naïve patients in each group was 93.3% and 95.7% ( P = .313), respectively. The overall SVR 12 rates of LDV/SOF for 12 weeks and GLE/PIB for 8 weeks were 99.3% (149/150) and 100% (232/232), respectively. We conducted 1:1 PSM to compare changes in the FIB-4 index before and after treatment. There was no significant difference in the on-treatment change of FIB-4 in the LDV/SOF and GLE/PIB group (3.0 ± 2.7 vs 2.8 ± 2.5, P = .518; 2.9 ± 2.5 vs 2.4 ± 3.4, P = .159). In addition, no significant difference in delta FIB-4 was shown between the groups in the PSM cohort ( P = .939). Furthermore, on stratifying by FIB-4 subclassification, no significant differences in on-treatment delta FIB-4 were observed between the groups across the low, intermediate, and high FIB-4 subclassification ( P = .909, 0.155, and 0.819, respectively). Fixed doses of LDV/SOF and GLE/PIB are effective for treating HCV GT-1 and GT-2 infections. There were no significant differences between the 2 regimens in on-treatment FIB-4 changes upon reaching SVR 12.