A 6-week regimen of sofosbuvir (Sovaldi) plus two experimental direct-acting antivirals being developed by Gilead Sciences cured more than 90% of previously untreated people with genotype 1 hepatitis C virus and no liver cirrhosis, according to a poster presentation at the European Association for the Study of the Liver (EASL) 50th International Liver Congress last month in Vienna. A 4-week regimen was not effective for any group, however, and 6 weeks appears inadequate for harder-to-treat patients. Other studies showed that the new drugs, GS-5816 (velpatasvir) and GS-9857, are also active against other HCV genotypes.
Now that interferon-free direct-acting antiviral (DAA) regimens taken for 12 weeks can cure most people with HCV genotype 1, researchers are working to develop new drugs that work against multiple HCV genotypes (known as ‘pan-genotypic’) and that can produce sustained viral suppression with a shorter duration of treatment, which would be more convenient for patients and could potentially lower costs.
Edward Gane of Auckland Clinical Studies in New Zealand and colleagues tested a three-drug regimen consisting of Gilead’s nucleotide HCV NS5B polymerase inhibitor sofosbuvir, the pan-genotypic NS5A inhibitor GS-5816 and the pan-genotypic NS3/4A HCV protease inhibitor GS-9857 taken for 4 or 6 weeks. Combining drugs that attack HCV at three different steps of its lifecycle may enable shorter treatment, the researchers hypothesized.
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