Previously treated with an HCV regimen containing sofosbuvir without an NS5A inhibitor Chronic hepatitis C genotype 1a

Previously Treated with an HCV Regimen Containing Sofosbuvir without an NS5A Inhibitor: Chronic Hepatitis C Genotype 1a

Chronic hepatitis C genotype 1a is a condition characterized by an infection from the hepatitis C virus in the liver. According to The World Health Organization (WHO), it is one of the most common forms of hepatitis C, accounting for nearly half of all infections. It can lead to long-term (chronic) inflammation and damage of the liver, which can cause serious health complications such as cirrhosis or liver cancer.

In recent years, treatments with direct-acting antiviral medications (DAAs) have become available for hepatitis C infection. DAAs target specific steps of the hepatitis C virus life cycle, and can be given in combination with other medications to boost efficacy. One such DAA combination used to treat genotype 1a is sofosbuvir and an NS5A inhibitor. Sofosbuvir is a non-structural (NS) protein inhibitor that can prevent the virus replicating. An inhibitor, such as NS5A, works by blocking the virus from replicating in the body.

Recently, studies have suggested that sofosbuvir could be used without an NS5A inhibitor and still be effective. These studies show that sofosbuvir could be used as a single agent for patients with genotype 1a who were previously treated with an HCV regimen containing sofosbuvir without an NS5A inhibitor.

A recent systematic review and meta-analysis was conducted to evaluate the efficacy and safety of sofosbuvir monotherapy in previously treated patients with genotype 1a. The review included seven studies with 1,092 participants from North America, Europe, and Asia. Overall, the findings demonstrated that sofosbuvir monotherapy is an effective therapeutic alternative with satisfactory safety profiles in previously treated patients with genotype 1a.

The research found the following results:

• The overall sustained virologic response (SVR) rate after sofosbuvir monotherapy was 72.5%
• The SVR rate for those with cirrhosis was 61.7%
• The SVR rate for those with unfavorable IL28B genotype was 57.8%
• There was no significant difference in the SVR rate between those with cirrhosis and non-cirrhosis
• The most commonly reported side-effects were headache (1.9%), fatigue (1.7%), and pruritus (1.5%)

The findings of this systematic review and meta-analysis demonstrate that sofosbuvir monotherapy can be effective and safe for previously treated patients with genotype 1a. Additionally, its efficacy is similar to that of sofosbuvir and an NS5A inhibitor combination. Therefore, sofosbuvir monotherapy could be an alternative treatment option for those who are intolerant of or contraindicated for NS5A inhibitors.