Ledipasvir/ sofosbuvir – rapid development of knowledge reduces treatment time

Czech version

Authors: P. Husa
Authors‘ workplace: Klinika infekčních chorob LF MU a FN Brno
Published in: Gastroent Hepatol 2015; 69(5): 473-476
Category: Hepatology: Review article
doi: https://doi.org/10.14735/amgh2015473

Overview

Ledipasvir and sofosbuvir in a fixed-dose single-tablet combination have a variety of therapeutic indications in patients infected with hepatitis C virus genotypes 1, 3, and 4. According to the current European Association for the Study of the Liver Guidelines, the duration of therapy with ledipasvir/sofosbuvir in combination with ribavirin is 12 weeks in cirrhotic patients infected with hepatitis C virus genotype 1 or 4. This recommendation includes patients with both compensated and decompensated liver cirrhosis, both pre- and post-liver transplantation. An extension of combination therapy to 24 weeks is indicated only in cirrhotic patients with negative predictive factors for the achievement of a sustained virologic response, especially with profound thrombocytopenia or when ribavirin is contraindicated or poorly tolerated. The last revision of the summary of product characteristics of Harvoni from June 2015 recommends 24 weeks of therapy with LDV/SOF alone in compensated cirrhosis and 24 weeks of ledipasvir/sofosbuvir in combination with ribavirin in decompensated cirrhosis in both pre- and post-transplantation patients. This contribution provides an analysis of this contradiction.

Key words:
chronic hepatitis C – hepatitis C virus – HCV – sofosbuvir – ledipasvir – ribavirin

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
14. 8. 2015

Accepted:
7. 9. 2015

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