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Does Vosevi cure hepatitis C?

Medically reviewed by Carmen Fookes, BPharm. Last updated on April 24, 2020.

Official Answer

by Drugs.com
  • Yes, Vosevi is a combination treatment that does cure hepatitis C (HCV) in most people depending on their genotype and prior exposure to other antiviral agents.
  • Cure rates range from 91% to 100% depending on a person's HCV genotype.

Vosevi is a combination treatment that contains 400mg of sofosbuvir, 100mg of velpatasvir, and 100mg of voxilaprevir. It is usually given as a single dose once a day with food.

It may be used to treat chronic hepatitis C in adults with genotypes 1 to 6, with or without cirrhosis, who have been already treated with an HCV regimen containing a NS5A inhibitor. It may also be used to treat adults HCV genotype 1a or 4 infection (without cirrhosis, or with compensated cirrhosis) that has previously been treated with a sofosbuvir regimen without an NS5A inhibitor.

How effective is Vosevi?

Trials evaluated how effective Vosevi was in people without cirrhosis or with compensated cirrhosis who had either previously received a NS5A inhibitor, or another type of antiviral treatment.

A cure is defined as a sustained virologic response (SVR) for a certain period (usually 12 weeks) and is usually written as SVR12. It reflects how long the hepatitis C virus is undetectable in the blood for.

An overall SVR12 rate of 96% was reported for all genotypes. This means that Vosevi cured 96% of people overall.

When looking at specific genotypes, cure rates in those that had previously received an NS5A inhibitor in a trial called POLARIS 1 were as follows:

  • Gentotype 1a: 96%
  • Genotype 1b: 100%
  • Genotype 2:100%
  • Genotype 3: 95%
  • Genotype 4: 91%
  • Genotype 5: 100%
  • Genotype 6: 100%.

Relapse rates of 5% were reported for genotypes 3 and 4, and a relapse rate of 1% of genotype 1a. No other genotypes had relapses.

Cure rates for people who had previously received other antivirals that were NOT NS5A inhibitors in a trial called POLARIS 4 (only administered to genotypes 1 to 4) were:

  • Gentotype 1a: 97%
  • Genotype 1b: 94%
  • Genotype 2:100%
  • Genotype 3: 96%
  • Genotype 4:100%.

What is Vosevi?

Vosevi contains three antiviral drugs: sofosbuvir, velpatasvir, and voxilaprevir.

Each works differently but they all affect viral growth and replication. By having three different antivirals with three different mechanisms of action increases the cure rate against the hepatitis C virus and reduces the risk of resistance developing.

Sofosbuvir interferes with the reproduction of genetic material of the hepatitis C virus, by inhibiting an RNA-dependent polymerase called HCV NS5B, which is also needed by the virus to replicate itself. Sofosbuvir is a prodrug, which means it is metabolized in the body to its active component and incorporated into the DNA of the HCV virus. Sofosbuvir also works directly on viral RNA and does not inhibit human DNA or RNA.

Velpatasvir is an NS5A (hepatitis C virus nonstructural protein 5A) inhibitor. Velpatasvir works by interfering with a protein, called HCV NS5A that is needed by the virus to replicate itself. This protein is the main target for velpatasvir, menaing velpatasvir works directly on the virus, not on human cells.

Voxilaprevir is reversible inhibitor of NS3/4A protease which is also essential for viral replication.

What are the side effects of Vosevi?

Vosevi is usually well tolerated, but the most common side effects reported include:

  • Headache
  • Fatigue
  • Itching
  • Asthenia (lack of energy)
  • Nausea or an upset stomach
  • Diarrhea
  • Difficulty sleeping.

Also, reactivation of hepatitis B has been reported in people who have a current or prior hepatitis B virus (HBV) infection before initiating treatment with Vosevi. In some cases, this has resulted in severe and rapid liver disease, hepatic failure, and death.

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