Non-structural protein 5A (NS5A) is important for RNA synthesis and virus assembly making it as an attractive target for intervention in chronic Hepatitis C virus (HCV) infection[3]. Elbasvir is a small molecule inhibitor of NS5A of HCV being developed as a component of treatment regimens for chronic HCV infection. In the 3-day replicon assay, the EC90 of elbasvir was 0.006 nM for both the wild-type 1a_H77 and 1b_con1 replicons. The EC90 of elbasvir ranged from 0.01 to 0.02 nM for genotype 1a and 0.01 to 0.03 nM for genotype 1b. In a phase 1 study, elbasvir once daily for 5 days resulted in mean reductions in HCV RNA levels of 3.7-5.1 log10 IU/mL in patients with genotype 1a or 1b infections when given 5-50 mg/day and of ~3 log10 IU/mL in patients with genotype 3 when given 50 or 100 mg/day. In later phase 2 trials, treatment with elbasvir combined with grazoprevir (an investigational once-daily NS3/4A-protease inhibitor) ± ribavirin for 12 weeks produced SVR12 (sustained virologic response) rates of 87-98% for patients with genotype-1 infections[4].
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