Sofosbuvir/Velpatasvir/Voxilaprevir Salvage Therapy in Hepatitis C Patients Who Relapsed After DAA Treatment

Despite the high cure rates achieved with direct-acting antiviral (DAA) therapies, a subset of patients with chronic hepatitis C virus (HCV) infection experience virologic relapse after treatment. Optimal retreatment strategies for these patients, particularly those with advanced liver disease or genotype 3 infection, remain an important clinical concern. This multicenter observational study was conducted across 24 academic centers in Hunan and Shanxi Provinces, China, to evaluate the real-world effectiveness and safety of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) as a salvage therapy. Adult patients with confirmed chronic HCV infection who relapsed following prior DAA therapy were enrolled and received a 12-week course of SOF/VEL/VOX. The use of ribavirin was permitted at the discretion of the treating physician. Virologic response was assessed by measuring HCV RNA levels during treatment and at 12 weeks after treatment completion to determine sustained virologic response (SVR12). Laboratory parameters, including liver function tests and hematologic indices, were monitored to evaluate treatment response and safety. Subgroup analyses were performed to explore the potential impact of baseline characteristics such as age, sex, liver cirrhosis status, viral genotype, and treatment regimen on treatment outcomes. Safety was assessed by recording adverse events throughout treatment and follow-up. This study aims to provide real-world evidence to support the use of SOF/VEL/VOX as an effective and well-tolerated retreatment option for patients with prior DAA failure, with particular attention to populations that are more difficult to treat.

Inclusion criteria

• Age ≥18 years at the time of enrollment
• Confirmed chronic hepatitis C virus (HCV) infection
• Documented virologic relapse after prior direct-acting antiviral (DAA) therapy
• Detectable HCV RNA at screening
• Received or planned to receive a 12-week regimen of sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) as salvage therapy
• Willing and able to provide written informed consent

Exclusion criteria

• Pregnant or breastfeeding women
• Participation in another interventional clinical study during the study period