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Indication
The fixed dose combination ledipasvir-sofosbuvir (90 mg/400 mg) is indicated for treatment, with or without ribavirin, for the treatment of patients with chronic hepatitis C genotypes 1, 4, 5, and 6. The detailed indications are listed below. When treating patients coinfected with HCV and HIV, the recommendations are the same as listed below.
Genotype 1

Treatment-naïve without cirrhosis or with compensated cirrhosis (Child-Pugh A) : ledipasvir-sofosbuvir x 12 weeks*
Treatment-experienced** without cirrhosis: ledipasvir-sofosbuvir x 12 weeks
Treatment experienced** with compensated cirrhosis (Child-Pugh A): ledipasvir-sofosbuvir x 24 weeks†
Treatment naïve and treatment experienced** with decompensated cirrhosis (Child-Pugh B or C): ledipasvir-sofosbuvir plus ribavirin‡ x 12 weeks
Genotype 1 or 4

Treatment-naïve and treatment-experienced ** liver transplant recipients without cirrhosis, or with compensated cirrhosis (Child-Pugh A): ledipasvir-sofosbuvir plus ribavirin§ x 12 weeks
Genotype 4, 5, or 6

Treatment-naïve and treatment-experienced ** without cirrhosis or with compensated cirrhosis (Child-Pugh A): ledipasvir-sofosbuvir plus ribavirin x 12 weeks

Side Effects
Nausea, severe dizziness, trouble breathing.
Mechanism Of Action
Ledipasvir is a potent inhibitor of HCV NS5A, a viral phosphoprotein that plays an important role in viral replication, assembly, and secretion. Sofosbuvir is a nucleotide analog inhibitor of hepatitis C virus NS5B polymerase—the key enzyme mediating HCV RNA replication. The triphosphate form of sofosbuvir (GS-461203) mimics the natural cellular uridine nucleotide and is incorporated by the HCV RNA polymerase into the elongating RNA primer strand, resulting in viral chain termination