The majority of the cases are caused by HCV genotypes 1 (70%) and 4, less frequently by types 2 and 3. The infection may lead to chronic hepatitis, decompensated cirrhosis, and hepatocellular carcinoma, causing as many as 350,000 deaths per year. Hepatitis C, caused by various genotypes of the Hepatitis C virus (HCV), currently infects more than 170 million people around the world. Adverse events that occurred include: Headache, insomnia, fatigue, nausea, dizziness, pruritis, upper respiratory tract infections, rash, back pain, grade 1 anemia, and grade 4 lymphopenia however, the exact safety profile can only be judged when this drug is actually used on a large scale. The efficacy and safety were demonstrated in many large and well-designed phase 2 and phase 3 clinical trials like NEUTRINO, PROTON, ELECTRON, ATOMIC, COSMOS, FUSION, FISSION, NUCLEAR, POSITRON, and the like. It offers many advantages due to its high potency, low side effects, oral administration, and high barrier to resistance. Sofosbuvir, a recently approved nucleotide analog, is a highly potent inhibitor of the NS5B polymerase in the Hepatitis C virus (HCV), and has shown high efficacy in combination with several other drugs, with and without PEG-INF, against HCV. There is an urgent need of new drugs with improved efficacy as well as a safety profile. The current standard of care for HCV infection, including one of the two protease inhibitors, telaprevir or boceprevir, for 12-32 weeks, along with pegylated interferon alfa-2a (PEG-IFN-α) and ribavirin for up to 48 weeks, is unsatisfactory in many cases, either because of lack of efficacy or because of treatment-related adverse effects. Hepatitis C currently infects more than 170 million people around the world, leading to significant morbidity and mortality.
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