***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To examine the safety and efficacy of ombitasvir and ABT-450 with ritonavir ( ABT-450/r ) ± ribavirin ( RBV ) in treatment-naïve , non-cirrhotic adults with chronic HCV genotype 1 - 3 infection . METHODS Patients in this open-label , exploratory , phase 2 , multicenter study received ombitasvir ( 25 mg QD ) and ABT-450/r ( 200/100 mg QD ) ± RBV for 12 weeks . Primary efficacy endpoint was HCV RNA < lower limit of quantitation ( LLOQ ) from week 4 through 12 . Sustained virologic response 12 weeks post-treatment ( SVR12 ) was a secondary endpoint . RESULTS Sixty-one patients were enrolled . Among genotype 1- , 2- , and 3-infected patients , respectively , HCV RNA was < LLOQ from week 4 through 12 in 10 ( 100 % ; 95 % CI 69 - 100 ) , 9 ( 90 % ; 56 - 100 ) , and 7 ( 70 % ; 35 - 93 ) receiving the RBV-containing regimen and 9 ( 90 % ; 56 - 100 ) , 8 ( 80 % ; 44 - 97 ) , and 2 ( 18 % ; 2 - 52 ) receiving the RBV-free regimen . Among genotype 1- , 2- , and 3-infected patients , respectively , SVR12 was achieved by 10 ( 100 % ) , 8 ( 80 % ) , and 5 ( 50 % ) receiving the RBV-containing regimen , and 6 ( 60 % ) , 6 ( 60 % ) , and 1 ( 9 % ) receiving the RBV-free regimen . The most common adverse events were fatigue , nausea , and headache . One patient discontinued due to an adverse event . CONCLUSIONS In this study , ombitasvir and ABT-450/r ± RBV regimens were generally well-tolerated . Sustained virologic response was achieved in most patients with HCV genotype 1 or 2 infection , but low SVR rates were observed in HCV genotype 3-infected patients BACKGROUND Sofosbuvir ( SOF ) is active against all hepatitis C virus ( HCV ) genotypes , and SOF-based therapies lead to high rates of sustained virologic response ( SVR ) . However , genotype 3 ( GT3 ) HCV remains a challenge with lower SVR rates reported , particularly in patients with cirrhosis . This study reports the effectiveness and safety of SOF-based therapy in patients with GT3 HCV treated in clinical practice . METHODS Hepatitis C Virus Therapeutic Registry and Research Network is an international , prospect i ve observational study evaluating patients treated in usual clinical practice . Patients with GT3 HCV were analyzed to assess predictors of treatment response and adverse events using descriptive statistics and multivariable logistic regression . RESULTS Treatment outcomes were available for 197 patients treated with SOF and ribavirin ( RBV ) , with or without peginterferon  , including 54 % with cirrhosis and 49 % who failed prior therapy . Of 178 patients treated with SOF/RBV  , 60 % achieved SVR at 12 weeks ( SVR12 ) , compared with 84 % of 19 patients treated with SOF/peginterferon/RBV . For patients treated with SOF/RBV , the SVR12 rate was 58 % in treatment-naive patients with cirrhosis , and 42 % in those with cirrhosis who failed prior therapy . In noncirrhotic patients  , SVR12 rates were 89 % in treatment-naive and 88 % in treatment-experienced patients . After controlling for age and sex , absence of cirrhosis ( odds ratio [ OR ] , 6.4 ; 95 % confidence interval [ CI ] , 2.78 - 14.74 ) , albumin levels ≥3.2 g/dL ( OR , 12.48 ; 95 % CI , 3.86 - 40.33 ) , and platelet count > 10(5 ) cells/µL ( OR , 7.44 ; 95 % CI , 3.51 - 15.78 ) were associated with greater odds of SVR12 CONCLUSIONS : SVR rates were acceptable in patients with GT3 HCV without cirrhosis ; however , in those with cirrhosis , treatment with SOF/RBV was suboptimal , highlighting the need for new therapies for this population Treatment options for patients with hepatitis C virus ( HCV ) genotype 3 infection are limited , with the currently approved all-oral regimens requiring 24-week treatment and the addition of ribavirin ( RBV ) . This phase III study ( ALLY-3 ; http:// Clinical Trials.gov : NCT02032901 ) evaluated the 12-week regimen of daclatasvir ( DCV ; pangenotypic nonstructural protein [NS]5A inhibitor ) plus sofosbuvir ( SOF ; pangenotypic NS5B inhibitor ) in patients infected with genotype 3 . Patients were either treatment naïve ( n = 101 ) or treatment experienced ( n = 51 ) and received DCV 60 mg plus SOF  400 mg once-daily for 12 weeks . Co primary endpoints were the proportions of treatment-naïve and treatment-experienced patients achieving a sustained virological response ( SVR ) at post-treatment week 12 ( SVR12 ) . SVR12 rates were 90 % ( 91 of 101 ) and 86 % ( 44 of 51 ) in treatment-naïve and treatment-experienced patients , respectively ; no virological breakthrough was observed , and ≥99 % of patients had a virological response ( VR ) at the end of treatment . SVR12 rates were higher in patients without cirrhosis ( 96 % ; 105 of 109 ) than in those with cirrhosis ( 63 % ; 20 of 32 ) . Five of seven patients who previously failed treatment with an SOF-containing regimen and 2 of 2 who previously failed treatment with an alisporivir-containing regimen achieved SVR12 . Baseline characteristics , including gender , age , HCV-RNA levels , and interleukin-28B genotype , did not impact virological outcome . DCV plus SOF was well tolerated ; there were no adverse events ( AEs ) leading to discontinuation and only 1 serious AE on-treatment , which was unrelated to study medications . The few treatment-emergent grade 3/4 laboratory abnormalities that were observed were transient . Conclusion : A 12-week regimen of DCV plus SOF achieved SVR12 in 96 % of patients with genotype 3 infection without cirrhosis and was well tolerated . Additional evaluation to optimize efficacy in genotype 3–infected patients with cirrhosis is underway . ( Hepatology 2015;61:1127–1135 Abstract Background & Aims ABT‐530 is a next‐generation hepatitis C virus ( HCV ) NS5A inhibitor with potent pangenotypic antiviral activity in vitro . Paritaprevir is an NS3/4A protease inhibitor codosed with ritonavir that displays in vitro activity against HCV genotypes 1–4 and 6 . Methods Efficacy , pharmacokinetics and safety of ABT‐530 with paritaprevir/ritonavir and ribavirin were evaluated in this phase 2 , open‐label , multicentre study in treatment‐naïve non‐cirrhotic patients with genotype 3 infection . Ten patients , all genotype 3a , received 120 mg ABT‐530 and 150/100 mg paritaprevir/ritonavir once daily with ribavirin for 12 weeks . Results Nine ( 90 % ) patients achieved a sustained virological response at post‐treatment weeks 12 and 24 . One patient experienced virological failure at treatment week 6 . Sequence analyses for HCV variants in sample s from this patient identified A166S in NS3 at baseline and after breakthrough , as well as A30 K at baseline and linked S24F+M28K+A30 K variants in NS5A after breakthrough . Neither genotype 3 NS3 A166S nor NS5A A30 K variant confers any resistance  to paritaprevir or ABT‐530 respectively . However , genotype 3 NS5A S24F+M28K+A30K‐linked variant confers a > 5000‐fold increase in ABT‐530 EC 50 relative to that of the wild‐type replicon . This patient 's ABT‐530 exposure was comparable to the cohort , while paritaprevir and ritonavir exposures were the lowest of all patients . No serious or severe adverse events and adverse events leading to early discontinuation were reported . Conclusions Results from this study show that ABT‐530 holds promise as part of a direct‐acting antiviral treatment regimen for HCV genotype 3 infection Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Patients chronically infected with hepatitis C virus ( HCV ) genotype 2 or 3 for whom treatment with peginterferon is not an option , or who have not had a response to prior interferon treatment , currently have no approved treatment options . In phase 2 trials , regimens including the oral nucleotide polymerase inhibitor sofosbuvir have shown efficacy in patients with HCV genotype 2 or 3 infection . METHODS We conducted two r and omized , phase 3 studies involving patients with chronic HCV genotype 2 or 3 infection . In one trial , patients for whom treatment with peginterferon was not an option received oral sofosbuvir and ribavirin  ( 207 patients ) or matching placebo ( 71 ) for 12 weeks . In a second trial , patients who had not had a response to prior interferon therapy received sofosbuvir and ribavirin for 12 weeks ( 103 patients ) or 16 weeks ( 98 ) . The primary end point was a sustained virologic response at 12 weeks after therapy . RESULTS Among patients for whom treatment with peginterferon was not an option , the rate of a sustained virologic response was 78 % ( 95 % confidence interval [ CI ] , 72 to 83 ) with sofosbuvir and ribavirin , as compared with 0 % with placebo ( P<0.001 ) . Among previously treated patients , the rate of response was 50 % with 12 weeks of treatment , as compared with 73 % with 16 weeks of treatment ( difference , -23 percentage points ; 95 % CI , -35 to -11 ; P<0.001 ) . In both studies , response rates were lower among patients with genotype 3 infection than among those with genotype 2 infection and , among patients with genotype 3 infection , lower among those with cirrhosis than among those without cirrhosis . The most common adverse events were headache , fatigue , nausea , and insomnia ; the overall rate of discontinuation of sofosbuvir was low ( 1 to 2 % ) . CONCLUSIONS In patients with HCV genotype 2 or 3 infection for whom treatment with peginterferon and ribavirin was not an option , 12 or 16 weeks of treatment with sofosbuvir and ribavirin was effective . Efficacy was increased among patients with HCV genotype 2 infection and those without cirrhosis . In previously treated patients with genotype 3 infection , 16 weeks of therapy was significantly more effective than 12 weeks . ( Funded by Gilead Sciences ; POSITRON and FUSION Clinical Trials.gov numbers , NCT01542788 and NCT01604850 , respectively . ) BACKGROUND & AIMS We conducted an open-label , r and omized , phase 3 trial to determine the efficacy and safety of sofosbuvir and ribavirin , with and without peginterferon-alfa , in treatment-experienced patients with cirrhosis and hepatitis C virus ( HCV ) genotype 2 infection and treatment-naïve or treatment-experienced patients with HCV genotype 3 infection . METHODS The study was conducted at 80 sites in Europe , North America , Australia , and New Zeal and Patients were r and omly assigned ( 1:1:1 ) to groups given sofosbuvir and ribavirin for 16 weeks ( n = 196 ) ; sofosbuvir and ribavirin for 24 weeks ( n = 199 ) ; or sofosbuvir , peginterferon-alfa , and ribavirin for 12 weeks ( n = 197 ) . The primary end point was the percentage of patients with HCV RNA < 15 IU/mL 12 weeks after stopping therapy ( sustained virologic response [ SVR12 ] ) . From October 2013 until April 2014 , we enrolled and treated 592 patients - 
    Output:
    
Treatment of patients with decompensated cirrhosis  remains a great challenge .
In summary , treatment of HCV genotype 3 patients is improving rapidly , and this population may no longer be considered a difficult-to-treat subgroup in the near future