Published online Jul 8, 2016. doi: 10.4254/wjh.v8.i19.785
Peer-review started: March 16, 2016
First decision: May 17, 2016
Revised: May 23, 2016
Accepted: June 14, 2016
Article in press: June 16, 2016
Published online: July 8, 2016
Processing time: 113 Days and 11.4 Hours
Hepatitis C virus (HCV) affects 3% of the world population. It represents the main cause of chronic liver disease and is responsible for extra-hepatic complications, such as type 2 diabetes and cardiovascular diseases. HCV includes 7 genotypes differing in the nucleotide sequence variability, the geographic distribution, the rates of viral clearance, the risk of progression to liver fibrosis and to hepatocellular carcinoma, and the response to therapy. Last years have seen remarkable advances in the field of HCV infection with the approval of direct antiviral agents (DAAs) targeting key viral proteins involved in the HCV replication. Several oral regimens combining DAAs from different families have been developed and these regimens showed increased and sustained virological response rates to above 90% reducing the treatment duration to 12 wk or less. In particular, sofosbuvir, a nucleotide analogue nonstructural (NS)5B polymerase inhibitor, and velpatasvir, a NS5A inhibitor, have been tested in two phase 3 trials, the ASTRAL-2 (against HCV genotype 2) and the ASTRAL-3 (against HCV genotype 3), demonstrating to be effective, safe, and well tolerated in patients who were 18 years of age or older and had at least a 6-mo history of HCV infection with a compensated liver disease.
Core tip: Hepatitis C virus (HCV) spread all over the world. In the last years, new therapies with direct antiviral agents draw a great revolution thanks to several oral regimens combining different drugs of this class. The present editorial provides a brief overview on the association between two direct antiviral agents, sofozsbuvir and velpatasvir, and their implication in the treatment of HCV infection.