Study to Investigate the Efficacy of Elbasvir/Grazoprevir Fixed-Dose Combination for 8 Weeks in Treatment-Naïve, HCV GT1b-Infected Patients, With Non-severe Fibrosis
Study to Investigate the Efficacy of Elbasvir/Grazoprevir Fixed-Dose Combination for 8 Weeks in Treatment-Naïve, HCV GT1b-Infected Patients, With Non-severe Fibrosis
A Phase 3, Global, Multicenter, Open-Label Study to Investigate the Efficacy of
 Elbasvir/Grazoprevir Fixed-Dose Combination for 8 Weeks in Treatment-Naïve, HCV GT1b-Infected
 Patients, with non-severe fibrosis

 The primary objectives of this study are as follows:

 -  To evaluate the efficacy of Elbasvir/Grazoprevir Fixed-Dose Combination for 8 Weeks in
 Treatment-Naïve, HCV GT1b-Infected Patients, with non- severe fibrosis as measured by
 the proportion of subjects with sustained viral response 12 weeks after cessation of
 treatment (SVR 12).

 -  To evaluate the safety and tolerability of EBV/GZR treatment

 The secondary objectives of this study are as follows:

 -  To determine the proportion of subjects who attain SVR at 4 and 24 weeks after cessation
 of treatment (SVR4 and SVR24)

 -  To evaluate the proportion of subjects with virologic failure

 -  To evaluate the kinetics of circulating HCV RNA during treatment and after cessation of
 treatment.

 -  To evaluate the emergence of viral resistance to EBV/GZR during treatment and after
 cessation of treatment
One hundred twenty treatment-naïve subjects with chronic HCV GT1b infection without cirrhosis
 will be enrolled.

 There will be one treatment group with EBV/GZR (50/100 mg) once daily without regards to food
 for 8 weeks.

 EBV/GZR is manufactured as a 50/100 mg tablet for oral administration. Subjects will take 1
 tablet daily.

 Screening assessments will be completed within 28 days of the Day 1 visit. The screening
 window can be extended to 42 days for subjects requiring a liver biopsy, or extenuating
 circumstances.

 All subjects will complete the following study visits: Screening, Day 1, and on-treatment
 visits at the end of week 2, week 4 and week 8.

 Post-treatment visits will occur at Weeks 4, 12, and 24 after last dose of study drug. All
 subjects will complete the posttreatment Week 4 and 12 visits. Subjects who achieve SVR12
 (HCV RNA < LLOQ at posttreatment Week12) will complete the posttreatment Week 24 visit.

 Screening assessments will include physical examination, medical history, height, weight,
 vital signs, adverse events related to screening procedures, concomitant medications, safety
 laboratory tests (including hematology, chemistry, and coagulation), HCV RNA, serology (HCV,
 HBV), serology and/or antigen testing for HIV, HCV genotyping, hemoglobin A1c (HbA1c),
 assessment of the absence of cirrhosis or severe fibrosis (including Fibrotest® and
 Fibroscan®), serum β-human chorionic gonadotropin (β-hCG) (females of child-bearing potential
 only), urinalysis.

 On-treatment assessments include adverse events (AEs), concomitant medications, study
 medication dispensation and pill count, physical examination, weight, vital signs, safety
 laboratory tests, HCV RNA, and urine pregnancy tests (females of child bearing potential
 only).

 Post-treatment assessments include AEs, concomitant medications, vital signs, safety
 laboratory tests (including hematology, chemistry, and coagulation), HCV RNA, and urine
 pregnancy tests (females of child-bearing potential only).
Inclusion Criteria:

 -  Willing and able to provide written informed consent

 -  Male or female, age ≥ 18 years

 -  Body Mass Index (BMI) ≥ 18 kg/m2

 -  HCV RNA ≥ 100 000 IU/mL at Screening

 -  Chronic HCV infection (≥ 6 months) documented by prior medical history or liver
 biopsy, only genotype 1b virus. (Positive for anti HCV antibody, HCV RNA, or an HCV
 genotype)

 -  Treatment-naïve with no prior exposure to any IFN, RBV, or approved or experimental
 HCV-specific DAA

 -  Non severe fibrosis (F<2) according to combination of this two tests :

 Fibroscan lower than 9.5kPa and Fibrotest lower than 0.59

 -  Females of childbearing potential (as defined in protocol Appendix 4) must have a
 negative serum pregnancy test at screening and a negative urine pregnancy test on Day
 1 prior to enrollment

 -  Male subjects and female subjects of childbearing potential who engage in heterosexual
 intercourse must agree to use 2 effective method(s) of contraception from at least two
 weeks prior to Day 1 through 14 days after the last dose of study drugs.

 -  If acceptable by local regulatory agencies, methods of birth control allowed in
 the study are: intrauterine device (IUD), diaphragm with spermicide, hormonal
 contraceptives (e.g., birth control pills, transdermal patch, or injectables),
 contraceptive sponge, female condom, male condom with spermicide or vasectomy.

 -  Note: Periodic abstinence (e.g., abstinence only on certain calendar days,
 abstinence only during ovulation period, use of symptothermal methods, use of
 post-ovulation methods and withdrawal) are not acceptable methods of
 contraception.

 -  A female subject who is not of reproductive potential is eligible without requiring
 the use of contraception. A female subjects who is not of reproductive potentials is
 defined as one who has either 1) reached natural menopause (defined as 12 months with
 no menses without an alternative medical cause), 2) 6 weeks post surgical bilateral
 oophorectomy with or without hysterectomy, or 3) bilateral tubal ligation.

 -  A male subject who is not of reproductive potential is eligible without requiring the
 use of contraception. A male subject who is not of reproductive potential is defined
 as: one who has undergone a successful vasectomy. A successful vasectomy is defined
 as: (1) microscopic documentation of azoospermia, or (2) a vasectomy more than 2 years
 ago with no resultant pregnancy despite sexual activity post vasectomy.

 -  Lactating females must agree to discontinue nursing before starting study drug

 -  Subject must be of generally good health, with the exception of chronic HCV infection,
 as determined by the Investigator

 -  Subject must be able to comply with the dosing instructions for study drug
 administration and able to complete the study schedule of assessments

 Exclusion Criteria:

 -  Is under the age of legal consent, is mentally or legally incapacitated, has
 significant emotional problems at the time of pre-study screening visit or expected
 during the conduct of the study or has a history of a clinically significant
 psychiatric disorder which, in the opinion of the investigator, would interfere with
 the study procedures.

 -  Current or prior history of any of the following:

 -  Clinically significant illness (other than HCV) or any other major medical
 disorder that may interfere with subject treatment, assessment or compliance with
 the protocol; subjects currently under evaluation for a potentially clinically
 significant illness (other than HCV) are also excluded

 -  Gastrointestinal disorder or post-operative condition that could interfere with
 the absorption of the study drug

 -  Difficulty with blood collection and/or poor venous access for the purposes of
 phlebotomy

 -  History of decompensation (e.g., clinical ascites, encephalopathy, and/or
 variceal hemorrhage)

 -  Solid organ transplantation (including hematopoietic stem cell transplants) other
 than kidney, cornea and hair.

 -  Significant cardiac disease

 -  Unstable psychiatric condition including hospitalization, suicidal attempt,
 and/or a period of disability as a result of their psychiatric illness within 2
 years prior to Screening

 -  Malignancy within the 5 years prior to Screening, with the exception of specific
 cancers that have been cured by surgical resection (e.g., basal cell skin cancer,
 etc.). Subjects under evaluation for possible malignancy are not eligible

 -  Significant drug allergy (e.g., hepatotoxicity)

 -  Subject has the following laboratory parameters at Screening:

 -  ALT > 10 x the upper limit of normal (ULN)

 -  AST > 10 x ULN

 -  Direct bilirubin > 1.5 x ULN

 -  Platelets < 75,000/μL

 -  HbA1c > 8.5%

 -  Creatinine clearance < 50 mL/min as calculated by the Cockcroft-Gault equation

 -  Hemoglobin < 10 g/dL

 -  Albumin < 3 g/dL

 -  INR > 1.5 x ULN unless subject has known hemophilia or is stable on an
 anticoagulant regime affecting INR

 -  Chronic liver disease of a non-HCV etiology (e.g., hemochromatosis, Wilson's disease,
 alfa-1 antitrypsin deficiency, cholangitis)

 -  Infection with hepatitis B virus (HBV) or human immunodeficiency virus (HIV)

 -  Clinically-relevant alcohol or drug abuse within 12 months of Screening.

 -  Alcohol, intravenous drugs, inhalational (not including marijuana), psychotropic,
 narcotics, cocaine use, prescription or over-the-counter drugs: within 1 year of
 the screening visit, or if shorter, is judged by investigator to be capable of
 complying with study procedures

 -  receiving opiate agonist substitution therapy within 1 year of screening visit,
 or if shorter, is judged by investigator to be capable of complying with study
 procedures

 -  history of marijuana use if deemed excessive by a physician investigator or
 interferes with the subject's daily function. If subject's marijuana use is not
 deemed excessive and does not interfere with daily function, subject must agree
 to discontinue any current use of recreational marijuana prior to entry into
 trial and throughout the trial period

 -  A positive drug screen will exclude subjects unless it can be explained by a
 prescribed medication; the diagnosis and prescription must be approved by
 the investigator

 -  Use of any prohibited concomitant medication listed in Section 5.5 of this protocol
 within 2 weeks prior to day 1.

 -  Known hypersensitivity to the study drug, the metabolites, or formulation excipient

 -  is currently participating or has participated in a study with an investigational
 compound within 30 days of signing informed consent and is not willing to refrain from
 participating in another study. Collection of additional blood, urine, or tissue
 samples or additional data, beyond that specified in this protocol, is prohibited
 (other than that related to subject's medical care).

 -  (female) is pregnant, lactating, expecting to conceive or donate eggs, or is of
 childbearing potential and unwilling to commit to two methods of birth control
 throughout treatment and after the completion of all treatment (see Inclusion
 Criteria); or male subject is planning to impregnate or provide sperm donation or has
 a female sexual partner of childbearing potential and is unwilling to commit to using
 a two methods of birth control throughout treatment and after the completion of all
 treatment (see Inclusion Criteria).

 -  had a life-threatening SAE during the screening period. 2. is a member or a family
 member of the investigational study staff or sponsor staff directly involved with this
 study.

 -  has evidence or history of chronic hepatitis not caused by HCV, including but not
 limited to nonalcoholic steatohepatitis (NASH), drug-induced hepatitis, and autoimmune
 hepatitis.

 -  NOTE: Subjects with history of acute non-HCV-related hepatitis, which resolved >
 6 months before study entry, may be enrolled.

 -  For subjects diagnosed with diabetes mellitus, documented HbA1c >8.5% (to exclude
 uncontrolled diabetes).

 -  Has any of the following conditions:.

 -  Subject with a history of gastric surgery (e.g., stapling, bypass) or subject
 with a history of malabsorption disorders (e.g., celiac sprue disease).

 -  Any medical condition requiring, or likely to require, chronic systemic
 administration of corticosteroids during the course of the trial.

 -  Has exclusionary laboratory values as listed below (see Table 5 for unit conversions
 of some laboratory values specified below):

 -  Note: If any of the laboratory exclusion criteria below are met, the site may
 have the abnormal value retested one time.

 Table 5: Exclusionary laboratory values:

 -  Laboratory Assessment

 -  hemoglobin < LLN (lower limit of normal) of laboratory reference range

 -  neutrophils <1.5 x 103/μL (<1.2 x 103/μL for Blacks)

 -  platelets <75 x 103/μL

 -  direct bilirubin >1.5 x ULN

 -  Total Bilirubin >1.6 mg/dL unless history of Gilbert's disease. (If Gilbert's disease
 is the proposed etiology, this must be documented in the subject's chart)

 -  Serum Albumin < 3.0 g/dL (lower limit of normal) of laboratory reference range

 -  creatinine clearance <50 mL/min

 -  INR >1.5

 -  ALT >350

 -  AST >350