Publication details
Ledipasvir/sofosbuvir - rychlý vývoj poznatků vede ke zkrácení léčby u cirhotických pacientů s chronickou hepatitidou C
| Title in English | Ledipasvir/sofosbuvir - rapid development of knowledge reduces treatment time |
|---|---|
| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Gastroenterologie a hepatologie |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.14735/amgh2015473 |
| Field | Epidemiology, infectious diseases and clinical immunology |
| Keywords | chronic hepatitis C; hepatitis C virus; HCV; sofosbuvir; ledipasvir; ribavirin |
| Description | Summary: Ledipasvir and sofosbuvir in a fixed-dose single-tablet combination have a variety of therapeutic indications in patients infected with hepatitis C virus genotypes 1, 3, and 4. According to the current European Association for the Study of the Liver Guidelines, the duration of therapy with ledipasvir/sofosbuvir in combination with ribavirin is 12 weeks in cirrhotic patients infected with hepatitis C virus genotype 1 or 4. This recommendation includes patients with both compensated and decompensated liver cirrhosis, both pre- and post-liver transplantation. An extension of combination therapy to 24 weeks is indicated only in cirrhotic patients with negative predictive factors for the achievement of a sustained virologic response, especially with profound throm-bocytopenia or when ribavirin is contraindicated or poorly tolerated. The last revision of the summary of product characteristics of Harvoni from June 2015 recommends 24 weeks of therapy with LDV/SOF alone in compensated cirrhosis and 24 weeks of ledipasvir/sofosbuvir in combination with ribavirin in decompensated cirrhosis in both pre- and post-transplantation patients. This contribution provides an analysis of this contradiction. |