Summary

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• This summary is based on the review of 10 systematic review(s)/meta-analysis(es). ^[1-10]
• Virological Failure and Resistance-Associated Substitutions (RAS): Sofosbuvir/velpatasvir exhibited virological failure rates comparable to other direct-acting antiviral (DAA) regimens, with a high prevalence of RAS at 78%. Similar RAS rates were observed in other regimens, including sofosbuvir/daclatasvir (81%) and glecaprevir/pibrentasvir (79%), while retreatment with sofosbuvir/velpatasvir/voxilaprevir showed an even higher RAS prevalence of 93%.
• Sustained Virological Response (SVR12) Across Populations: In genotype 2 (GT2) patients, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir achieved a 100% SVR12 rate. Among pediatric and adolescent patients, sofosbuvir/velpatasvir achieved SVR12 rates of 95% in adolescents, 93% in older children, and 83% in young children. For end-stage renal disease (ESRD) patients, the SVR12 rate with sofosbuvir/velpatasvir was 97.69%, and for decompensated cirrhotic patients, it reached 91%, outperforming other sofosbuvir-based regimens such as sofosbuvir/ledipasvir (86.3%) and sofosbuvir/daclatasvir (82.4%).
• Kidney Transplant Recipients and Other Genotypes: Kidney transplant recipients treated with sofosbuvir/velpatasvir achieved complete viral eradication at 12 weeks post-treatment. Additionally, genotype 3 patients treated with sofosbuvir/velpatasvir achieved an SVR12 rate of 95.08%, underscoring the regimen's efficacy across different genotypes.
• Common and Serious Adverse Events (AEs): Fatigue (14%) and headache (13.1%) were the most common adverse events associated with sofosbuvir/velpatasvir. Serious adverse events (SAEs) and deaths were uncommon overall, though grade 3 hyperglycemia occurred in 2.1% of diabetic patients treated with sofosbuvir/velpatasvir/voxilaprevir.
• Pediatric and Special Populations: Younger children experienced higher rates of adverse events (72%) compared to adolescents (50%) and older children (53%). Among end-stage renal disease (ESRD) patients, no serious adverse events were reported with sofosbuvir/velpatasvir. In decompensated cirrhotic patients, adding ribavirin to sofosbuvir-based regimens led to a notable increase in adverse event frequency.