Meeting report: 30th International Conference on Antiviral Research, in Atlanta, GA, USA

Vere Hodge, R Anthony

In sofosbuvir Phase III studies, four separate trials recruited patients with different genotypes, 1 and 4, 2, 3 and 5 and 6, respectively. By this time, the SVR for 12 weeks (SVR 12 ) had become the accepted measure for an HCV cure. The SVR 12 were 90, 97, 93 and 100%, respectively. To further optimise the cure rates, Gilead combined sofosbuvir with an NS5A inhibitor, ledipasvir, which became Harvoni V R . However, ledipasvir has now been largely replaced by velpatasvir, another NS5A inhibitor but with an improved genetic barrier to resistance. This combination is Epclusa V R which gives >96% cure rate for all genotypes 1-6. Sofosbuvirbased cure regimens have been shown to be effective in patients co-infected with HIV, in previously difficult- ) received approval from the USA Food and Drug Administration (FDA) in December 2013. Since then, more than a million patients have been cured on sofosbuvir-based regimens. Although at least 15 nucleoside/tide drugs have entered clinical development, sofosbuvir remains the only approved nucleoside/tide drug for HCV therapy. It is the drug of choice to act as the 'backbone' of HCV combination therapies -only sofosbuvir has a sufficiently high genetic barrier to viral resistance combined with an excellent safety profile. HCV could become a rare disease if the issues regarding patient access can be resolved.