title: Combination ledipasvir-sofosbuvir for the treatment of chronic hepatitis C virus infection: a review and clinical perspective.
abstract: Chronic hepatitis C treatment has continued to evolve, and interferon-free, oral treatment with direct-acting antiviral agents is the current standard of care. Recently, a new treatment, which is a combination of two direct-acting antiviral agents, ledipasvir 90 mg (anti-NS5A) and sofosbuvir 400 mg (anti-NS5B), has been approved in the US and the European Union for the treatment of chronic hepatitis C viral infection. In Phase III trials among chronic hepatitis C virus genotype 1 monoinfected (treatment-naïve, treatment-experienced, and with advanced liver disease or posttransplant) patients and HIV-hepatitis C virus coinfected patients, the ledipasvir-sofosbuvir fixed-dose combination is associated with a higher rate of sustained virologic response at 12 weeks after therapy has ceased. According to preliminary data, the ledipasvir-sofosbuvir combination also may be effective against hepatitis C genotype 4 virus infection. The ledipasvir-sofosbuvir combination taken orally is generally well-tolerated. Moreover, the combination treatment may suppress the effect of predictive factors of chronic hepatitis C that have historically been known to be associated with treatment failure. Thus, the fixed-dose single-tablet combination of ledipasvir-sofosbuvir offers a new era for the effective treatment of a variety of patients suffering from chronic hepatitis C virus infection.
authors.affiliation: Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Marcel
authors.initials: M
authors.lastname: Nkuize
authors.affiliation: Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, Brussels, Belgium; Department of Gastroenterology, Pancreatology and Hepatology, Hôpital Academique Erasme, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sersté
authors.affiliation: Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Buset
authors.affiliation: Department of Gastroenterology and Hepatology, Saint-Pierre University Hospital, Brussels, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Mulkay
keywords: DAA; HIV; ethnicity; ledipasvir; liver disease