Hur effektiv och säker är kombinationen av sofosbuvir och velpatasvir mot kronisk hepatit C-infektion

Sammanfattning: Around 130-150 million people are chronically infected with hepatitis C-virus today. Personal suffering and great societal costs aside, this also causes around 400 000 deaths every year due to complications. Earlier treatments with pegylated interferon and ribavirin were both ineffective and had a lot of side effects, but in recent years new treatments using direct-acting antivirals that are both more effective and has less side effects have been introduced. The downside with these are that their effectiveness depends on which HCV genotype the patient has, which requires costly and time consuming pre-treatment examinations before treatment can begin. This paper investigates clinical studies in which the effectiveness and side effects of a new combination of drugs containing sofosbuvir and velpatasvir is tested. The studies where found through PubMed, and they are what the usage of these drugs in health care is based on. The studies show that the combination of sofosbuvir and velpatasvir is effective, measured by sustained virological response, against all HCV genotypes irrespective of if the patient has a compensated or decompensated cirrhosis, or if the patient has had a previously failed treatment. The patients with decompensated cirrhosis also had an early improvement in liver function, but it is too early to say if the improvement is long lasting. The treatment also gave less side effects compared to pegylated interferon and ribavirin. The combination of sofosbuvir and velpatasvir was also shown to have a good effect amongst patients where resistance associated variants of NS5A and NS5B where found. The conclusion is that the combination of sofosbuvir and velpatasvir is an effective, but also at the moment expensive, treatment for HCV independent of genotype.