Citius, Altius, Fortius: The New Paradigm in the Treatment of Chronic Hepatitis C Disease

  title={Citius, Altius, Fortius: The New Paradigm in the Treatment of Chronic Hepatitis C Disease},
  author={George M. Abraham and Linda M. Spooner},
  journal={Clinical Infectious Diseases},
With the advent of the direct-acting antiviral agents (DAAs) for chronic hepatitis C infection, the treatment paradigm has dramatically changed, especially the duration, tolerability, and response to therapy. The DAAs fall into several classes and are variously indicated in the treatment of one or more genotypes of infection. All these agents are orally administered and, as they are largely renally eliminated (with exceptions), do not require adjustment in mild to moderate renal insufficiency… 

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Sofosbuvir in the treatment of chronic hepatitis C: new dog, new tricks.
  • G. Abraham, Linda M. Spooner
  • Biology, Medicine
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • 2014
Sofosbuvir, an oral nucleotide inhibitor of the HCV nonstructural protein 5B RNA-dependent RNA polymerase enzyme, was recently approved for use in combination with ribavirin and/or pegylated interferon for chronic HCV infection, depending on the genotype.
NS5A inhibitors in the treatment of hepatitis C.
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Sofosbuvir and Velpatasvir for HCV Genotype 1, 2, 4, 5, and 6 Infection.
Once-daily sofosbuvir-velpatasvir for 12 weeks provided high rates of sustained virologic response among both previously treated and untreated patients infected with HCV genotype 1, 2, 4, 5, or 6, including those with compensated cirrhosis.
Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease.
The combination of ledipasvir, sofosbuvir, and ribavirin for 12 weeks produced high rates of SVR12 in patients with advanced liver disease, including those with decompensated cirrhosis before and after liver transplantation.
GrazoprevirElbasvir Combination Therapy for Treatment-Naive Cirrhotic and Noncirrhotic Patients With Chronic Hepatitis C Virus Genotype 1, 4, or 6 Infection
This phase 3 trial found a once-daily grazoprevirelbasvir regimen to be effective and well-tolerated in patients with HCV genotype 1, 4, or 6 infection and represents a new therapeutic option for chronic HCV infection.
Daclatasvir plus Sofosbuvir for HCV in Patients Coinfected with HIV-1.
Among previously untreated HIV-HCV coinfected patients receiving daclatasvir plus sofosbuvir for HCV infection, the rate of sustained virologic response across all genotypes was 97.3% after 12 weeks of treatment and 76.0% after 8 weeks, respectively.
Ledipasvir and Sofosbuvir for HCV in Patients Coinfected with HIV-1.
Ledipasvir and sofosbuvir as a single fixed-dose combination for 12 weeks provided high rates of sustained virologic response in patients coinfected with HIV-1 and HCV genotype 1 or 4.
Sofosbuvir and ribavirin for hepatitis C in patients with HIV coinfection.
Patients with HIV who were coinfected with HCV genotype 1, 2, or 3 who received the oral, interferon-free combination of sofosbuvir and ribavirin for 12 or 24 weeks had high rates of SVR12, the proportion of patients with SVR 12 12 weeks after cessation of HCV therapy.
Sofosbuvir, Velpatasvir, and Voxilaprevir for Previously Treated HCV Infection
Sofosbuvir‐velpatasvir‐voxilaprevir taken for 12 weeks provided high rates of sustained virologic response among patients across HCV genotypes in whom treatment with a DAA regimen had previously failed.