, Volume 74, Issue 10, pp 1127-1146
Date: 24 Jun 2014

Sofosbuvir: A Review of its Use in Patients with Chronic Hepatitis C

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Abstract

Sofosbuvir (Sovaldi®) is a nucleotide hepatitis C virus (HCV) NS5B polymerase inhibitor that has pangenotypic antiviral activity and a high genetic barrier to resistance. This article reviews the clinical efficacy and tolerability of sofosbuvir in patients with chronic hepatitis C and summarizes its pharmacological properties. Interferon-free treatment with sofosbuvir plus ribavirin achieved high sustained virological response (SVR) rates in treatment-naïve and treatment-experienced patients with HCV genotype 2 or 3 infection, and also had efficacy in patients with HCV genotype 1 infection. Sofosbuvir plus ribavirin was also effective in patients co-infected with HCV and HIV, and sofosbuvir plus ribavirin administered prior to liver transplantation prevented recurrent HCV infection in the majority of patients who had HCV RNA levels below the limit of quantification at the time of transplantation. Sofosbuvir plus peginterferon-α-2a and ribavirin achieved high SVR rates in patients with HCV genotype 1 infection, and also appeared effective in patients with HCV genotype 4, 5 or 6 infection. Oral sofosbuvir was generally well tolerated in patients with chronic hepatitis C. The most commonly reported adverse events and laboratory abnormalities were consistent with those expected with ribavirin and peginterferon-α. In conclusion, sofosbuvir represents an important advance in the treatment of chronic hepatitis C.

The manuscript was reviewed by: W. Cheng, Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, WA, Australia; R. Esteban, Liver Unit, Hospital General, Universitario Valle Hebron and CIBERHED del Instituto Carlos III, Barcelona, Spain; P.J. Pockros, Division of Gastroenterology and Hepatology, Scripps Clinic and Scripps Translational Science Institute, La Jolla, CA, USA.