Weisberg Ilan S, Jacobson Ira M
a Division of Digestive Diseases , Mount Sinai Beth Israel Medical Center , New York , NY , USA.
Expert Opin Pharmacother. 2017 Apr;18(5):535-543. doi: 10.1080/14656566.2017.1282459. Epub 2017 Mar 24.
Hepatitis C virus (HCV) infects nearly 170 million people worldwide and is a leading cause of progressive liver damage, cirrhosis, and hepatocellular carcinoma. Curative therapies have historically relied on interferon-based treatments and were limited by significant toxicity and poor response rates, particularly among patients with prior treatment failure and advanced hepatic fibrosis. The recent advent of direct acting antiviral (DAA) agents which target key steps in the HCV viral life cycle has transformed the landscape of HCV treatment by offering highly effective and well tolerated interferon-free treatments. However, current therapies are genotype-specific and have variable efficacy amongst less prevalent HCV variants. Areas covered: This review covers the preclinical and clinical development of sofosbuvir/velpatasvir (SOF/VEL), an interferon-free, once daily, pangenotypic treatment for the treatment of chronic hepatitis C virus (HCV) infection. All relevant literature from 2014 through September of 2016 is included. Expert opinion: SOF/VEL offers the promise of a single tablet, interferon- and ribavirin-free treatment that has extremely high efficacy in persons with chronic HCV infection regardless of genotype, subtype, treatment history or fibrosis status. It is expected to play a major role on a global scale in the therapeutic armamentarium against this ubiquitous threat to human health.
丙型肝炎病毒(HCV)在全球感染了近1.7亿人,是导致进行性肝损伤、肝硬化和肝细胞癌的主要原因。从历史上看,治愈性疗法依赖于基于干扰素的治疗,但受到显著毒性和低反应率的限制,特别是在既往治疗失败和晚期肝纤维化患者中。最近出现的直接作用抗病毒(DAA)药物靶向HCV病毒生命周期的关键步骤,通过提供高效且耐受性良好的无干扰素治疗,改变了HCV治疗的格局。然而,目前的疗法是基因型特异性的,对不太常见的HCV变体的疗效各不相同。涵盖领域:本综述涵盖了索磷布韦/维帕他韦(SOF/VEL)的临床前和临床开发,这是一种用于治疗慢性丙型肝炎病毒(HCV)感染的无干扰素、每日一次的泛基因型治疗药物。纳入了2014年至2016年9月的所有相关文献。专家观点:SOF/VEL有望实现单片、无干扰素和无利巴韦林的治疗,对慢性HCV感染者,无论其基因型、亚型、治疗史或纤维化状态如何,均具有极高的疗效。预计它将在全球范围内的治疗手段中发挥重要作用,应对这种对人类健康普遍存在的威胁。