Evaluation of ledipasvir plus sofosbuvir for treatment of compensated and decompensated HCV cirrhotic patients

ABSTRACT

Background: unlike human immunodeficiency virus [HIV] and hepatitis B virus [HBV], hepatitis C virus [HCV] infection is a curable disease. Current direct acting antiviral agent [DAA] targets are focused on HCV NS3/4A protein [protease], NS5B protein [polymerase] and NS5A protein. The first generation of DAAs includes boceprevir and telaprevir, which are protease inhibitors and were approved for clinical use in 2011. The cure rate for genotype 1 patients increased from 45% to 70% when boceprevir or telaprevir was added to standard PEG-IFN/ribavirin. More effective and less toxic second generation DAAs supplanted these drugs by 2013. The second generation of DAAs includes sofosbuvir, simeprevir and fixed combination medicines containing ledipasvir plus sofosbuvir and Viekira Pak. These drugs increase cure rates to over 90% without the need for interferon and effectively treat all HCV genotypes. With these drugs the "cure HCV" goal has become a reality. The aim of this study was to assess of ledipasvir plus sofosbuvir as treatment of HCV infection in patients with advanced liver disease including cirrhotic patients with child B and C