Published online Feb 12, 2015. doi: 10.5501/wjv.v4.i1.33
Peer-review started: September 2, 2014
First decision: November 19, 2014
Revised: December 3, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: February 12, 2015
Processing time: 141 Days and 2.8 Hours
Hepatitis C virus (HCV) has infected more than 200 million people around the globe. From 2001-2011, interferon plus ribavirin remained the standard of care for patients with HCV infection. The therapy had a limited response with a number of side effects. Recently, results for phase III trials of ledipasvir and sofosbuvir combination therapy have been announced. In treatment naïve patients, 12 wk of therapy with ledipasvir and sofosbuvir showed a sustained virological response (SVR) rate of 99%. In treatment experienced patients, 12-24 wk of therapy with ledipasvir and sofosbuvir in the absence or presence of ribavirin showed an SVR rate of 94%-99%. In cirrhotic patients the rate of SVR was 86% and 99% for 12 and 24 wk of therapy, respectively. The ledipasvir and sofosbuvir therapy showed very good results in different subgroups of patients regardless of patient’s race, alanine aminotransferase levels, sex and host genetic factors. The combination therapy was well tolerated with no emergence of resistant mutants. The most common adverse effects were nausea, headache and fatigue. With the availability of interferon free therapy with minimal adverse effects, it will be easy to decrease the future morbidity and mortality caused by HCV infection.
Core tip: The interferon based therapy for hepatitis C patients has a limited response with a number of adverse effects. The ledipasvir and sofosbuvir combination therapy showed a sustained virological response (SVR) rate of 99% in treatment naïve patients. The rate of SVR was 94%-99% in treatment experienced patients, while in cirrhotic patients the rate of SVR was 86%-99%. The treatment response was not affected by ethnicity or host genetic factors.