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What is Which of these is a new oral drug used in treatment of chronic Hepatitis C? and explain in detail?
Ans. b. Ledipasvir (Ref: Harrison 19/ep2049, I8fe p2556.tLedipasvir is an inhibitor of the hepatitis C virus NS5A protein. Ledipasvir is most commonly used in combination with sofosbuvir for treatment in chronic hepatitis C genotype l patients." Ledipasvir is an inhibitor of the hepatitis C virus NS5A protein. Sofosbuvir, on the other hand, is metabolized to the active uridine analog triphosphate, which acts as a RNA chain terminator when incorporated into the RNA via the NS5B polymerase. ''LedipasvirLedipasvir is an inhibitor of the hepatitis C virus NS5A proteinQ.The ledipasvir/sofosbuvir combination is a direct-acting antiviral agent that interferes with HCV replication and can be used to treat patients with genotypes 1a or 1b without PEG-interferon or ribavirin.On October 10, 2014 the FDA approved the combination product Icdipasvir/sofosbuvir called Harvoni.Mechanism of Action:Ledipasvir inhibits an important viral phosphoprotein, NS5A, which is involved in viral replication, assembly & secretionClinical Uses:Ledipasvir is most commonly used in combination with sofosbuvir for treatment in chronic hepatitis C genotype1 patientsQ.Side-effects:MC side effects: Fatigue & headacheAntiviral Therapy in Hepatitis CIndications for Antiviral Therapy in Hepatitis CDetectable HCV RNA (with or without elevated ALT)Portal/bridging fibrosis or moderate to severe hepatitis on liver biopsyInitial Recommended Treatment depends on the Type of Hepatitis C virusGenotypeRecommended TreatmentHCV genotype 1a* 12 weeks of ledipasvir & sofosbuvir OR 12 -24 weeks of paritaprevir, ombitasvir, dasabuvir & ribavirinHCV genotype 1b* 12 weeks of ledipasvir & sofosbuvir OR 12 weeks of paritaprevir, ombitasvir & dasabuvirHCV genotype 2* 12 to 16 weeks of sofosbuvir & ribavirinHCV genotype 3* 12 weeks of sofosbuvir, ribavirin & pegylated interferonHCV genotype 4* 12 weeks of ledipasvir & sofosbuvir OR paritaprevir, ritonavir, ombitasvir & ribavirin, OR* 24 weeks of sofosbuvir & ribavirinHCV genotype 5 or 6* Sofosbuvir & ledipasvir