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The centers for disease control and Prevention has recently advocated routine screening for hepatitis C (HEP-C) among all adults born from 1945-1965. These recommendations stem from the observation of the ever-growing burden of persons with HEP-C and its consequences who do not necessarily endorse traditionally recognized risk factors for HEP-C such as intravenous drug use, tattoos, etc. Early identification allows for potential cure of HEP-C, since as many as 80% of previously untreated individuals can achieve sustained virologic response with “standard” antiviral regimens (e.g., ribaviron plus interferon).
This does, however, leave a substantial minority of HEP-C patients (those who fail treatment, who are intolerant of treatment, or who have contraindications to it) at risk. Fortunately sofosbuvir, a new polymerase inhibitor, has demonstrated high efficacy in both untreated HEP-C and treatment failures.
Sofosbuvir was studied in two populations of HEP-C genotype 2 or 3: persons with contraindications to interferon and cases that had not responded to interferon therapy. Sustained virologic response was seen in 78% of subjects with interferon contraindications, and (at 16 weeks) 73% of interferon failures. Sofosbuvir was generally well tolerated, with a discontinuation rate of 1-2%.