Abstract
Hepatitis C virus (HCV) infection is a disease that affects millions of people worldwide and has an enormous global public health impact. Chronic HCV is a long-term infection that goes unnoticed until the virus destroys the liver enough to induce liver disease symptoms. The inadequate and poorly tolerated treatment contributes to the burden of chronic HCV. Treatments have improved over time - direct-acting antivirals (DAAs) that targeted different hepatitis C virus genomic sites have shown to be more effective and well-tolerated. Patients recover to a greater extent following a treatment regimen based on DAAs. We conducted this literature review to investigate the effectiveness of these medications in treating chronic HCV infection. Relevant articles were identified by searching PubMed and Google scholar databases. Our primary goal was to analyze the efficacy and safety of the DAA, sofosbuvir plus velpatasvir, with or without ribavirin, in cirrhotic or non-cirrhotic, naïve or previously treated, chronic HCV patients. We found that treating patients with sofosbuvir-velpatasvir for 12 weeks was highly effective with fewer adverse events, including those with compensated cirrhosis. The outcomes aided in improving HCV treatment, lowering the disease's burden and fatality rate.
Highlights
BackgroundHepatitis C virus (HCV) infection is caused by an RNA virus, a member of the Flaviviridae family, and has six different genotypes [1]
Duration of retreatment in chronic hepatitis C virus patients with relapse Patients treated for shorter durations with all-oral non-structural protein 5A (NS5A) direct-acting antiviral (DAA) had higher re-treatment sustained virologic response (SVR) rates than those initially treated for longer durations (10-12 weeks) [29]
SVR12: Sustained virologic response at 12 weeks after treatment is completed; randomized controlled trials (RCTs): Randomized Controlled Trial; S: Sofosbuvir; V: Velpatasvir; hepatitis C virus (HCV): Hepatitis C Virus; GT: Genotype; DAAs: Direct-acting antivirals; D: Daclatasvir; VOX: Voxilaprevir; PIB: Pibrentasvir; GLE: Glecaprevir; GZR: Grazoprevir; RZR: Ruzasvir; MK-3682: Uprisofbuvir; genotype 3 (GT3): Genotype 3; RBV: Ribavirin; P: Pegylated-interferon; S+V+(RBV): Sofosbuvir combined with velpatasvir; S+RBV+( P): Sofosbuvir combined with ribavirin; S+L+(RBV): Sofosbuvir combined with ledipasvir; S+V+(RBV): Sofosbuvir combined with velpatasvir; S+D+ (RBV): Sofosbuvir combined with daclatasvir; adverse events (AE): Adverse events; NA: Not applicable; L: Ledipasvir; NS5A: Nonstructural protein 5A
Summary
Hepatitis C virus (HCV) infection is caused by an RNA virus, a member of the Flaviviridae family, and has six different genotypes [1]. Duration of retreatment in chronic hepatitis C virus patients with relapse Patients treated for shorter durations (four-eight weeks) with all-oral non-structural protein 5A (NS5A) direct-acting antiviral (DAA) had higher re-treatment sustained virologic response (SVR) rates than those initially treated for longer durations (10-12 weeks) [29]. Ruane et al conducted an open-label trial to assess the efficacy of sofosbuvir/velpatasvir/vocilaprevir (SOF/VEL/VOX) for 12 weeks in chronic HCV patients who previously did not achieve SVR receiving SOF/VEL containing regimen [31].
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