How well does Sovaldi work?

Sovaldi (sofosbuvir) is highly effective in treating hepatitis C (HCV) when used alongside at least one other HCV treatment. Its effectiveness and safety have been studied in at least seven trials, including one involving children aged three and older. Sovaldi can cure HCV in the majority of people who take it exactly as directed.

Success of treatment is gauged by something called sustained virologic response (SVR), which means the hepatitis C virus becomes undetectable in the blood. Here's the breakdown: after 12 weeks (SVR12), Sovaldi achieved a 90% cure rate for genotype 1 (92% for genotype 1a and 83% for genotype 1b), 95% for genotype 2, 84% for genotype 3, and 96% for genotype 4.

In simpler terms, 90% of people with genotype 1 HCV given Sovaldi were cured, while 96% of those with genotype 4 were cured. However, some people experienced relapse after treatment: 9% with genotype 1 or 4, 5% with genotype 2, and 14% with genotype 3.

Overall, cure rates were higher in those without liver cirrhosis compared to those with cirrhosis, and in non-black individuals compared to black individuals. Additionally, those with specific gene variants (IL28B C/C alleles) had higher cure rates.

The recommended dose of Sovaldi is 400mg taken orally once a day, with or without food.

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How does Sovaldi work?

Sofosbuvir disrupts the hepatitis C virus's ability to reproduce genetic material by targeting an RNA-dependent polymerase known as HCV NS5B, essential for the virus's replication process.

As a prodrug, Sofosbuvir undergoes metabolism in the body to activate its main component, which then integrates into the DNA of the HCV virus. Importantly, Sofosbuvir acts directly on viral RNA without interfering with human DNA or RNA.

Sovaldi (sofosbuvir) made waves in 2013 upon FDA approval for treating chronic hepatitis C alongside other medications, typically ribavirin. It marked a significant advancement by offering a cure for certain chronic hepatitis C genotypes and provided a treatment avenue for individuals who couldn't tolerate interferon-based therapies or those awaiting liver transplantation due to cancer, meeting critical medical needs.

Today, Sofosbuvir is predominantly administered in fixed-dose combinations like Harvoni (with Ledipasvir) or Epclusa (with velpatasvir). While it was previously used with ribavirin and sometimes peginterferon alfa, these combinations are hardly used anymore.