Sofosbuvir for the treatment of patients with genotype 2 or 3 chronic hepatitis C virus infection

Author(s): Christoph Honer zu Siederdisse & Markus Cornberg

Treatment of chronic hepatitis C will dramatically change with the introduction of direct antiviral agents that allow interferon-free treatment schedules. However, most of the currently developed direct antiviral agents focus on genotype 1. Thus, other genotypes, especially genotype 3 will become more difficult to treat with interferon-free regimens in the near future in comparison with genotype 1. Hepatitis C virus genotype 3 may convert to the most problematic genotype as not only interferon-free therapies are more challenging but also progression to cirrhosis is faster. Sofosbuvir, a NS5B nucleoside HCV polymerase inhibitor is one of the direct antiviral agents that has pangenotypic efficacy. Phase III trials investigating sofosbuvir plus ribavirin treatment in patients with hepatitis C virus genotype 2 and 3 infection have been completed and sofosbuvir was approved by the US FDA and European Medicines Agency.